Healthcare Provider Details

I. General information

NPI: 1821679481
Provider Name (Legal Business Name): ANDREW YAZJI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 13TH ST SW
LARGO FL
33770-3127
US

IV. Provider business mailing address

PO BOX 2410
LARGO FL
33779-2410
US

V. Phone/Fax

Practice location:
  • Phone: 813-253-2727
  • Fax: 813-253-2729
Mailing address:
  • Phone: 813-253-2727
  • Fax: 813-253-2729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME179573
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: