Healthcare Provider Details

I. General information

NPI: 1487283065
Provider Name (Legal Business Name): ARYANNA ISMAILI JORDAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARYANNA QIBARET ISMAILI

II. Dates (important events)

Enumeration Date: 04/05/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 N MCMULLEN BOOTH RD STE 200
CLEARWATER FL
33761-2046
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 727-216-1141
  • Fax: 727-796-1590
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME161399
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME161399
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: