Provider Demographics
NPI:1841460185
Name:AZHARIAN, ANAHITA (DO)
Entity type:Individual
Prefix:
First Name:ANAHITA
Middle Name:
Last Name:AZHARIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 HEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1160
Mailing Address - Country:US
Mailing Address - Phone:954-646-7243
Mailing Address - Fax:
Practice Address - Street 1:2611 HEATHERWOOD DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1160
Practice Address - Country:US
Practice Address - Phone:954-646-7243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0T010986208600000X
FLOS11384208200000X
NY259049-1208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery