Healthcare Provider Details

I. General information

NPI: 1437402294
Provider Name (Legal Business Name): YANA GEYVANDOVA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 02/14/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 LITTLE RD
NEW PORT RICHEY FL
34655-1105
US

IV. Provider business mailing address

14690 SPRING HILL DR STE 305
SPRING HILL FL
34609-8102
US

V. Phone/Fax

Practice location:
  • Phone: 727-372-1005
  • Fax: 727-372-1009
Mailing address:
  • Phone: 352-277-5348
  • Fax: 352-606-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9219888
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: