Healthcare Provider Details

I. General information

NPI: 1588261663
Provider Name (Legal Business Name): PARIA MAGHSOUDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12198 SUMTER DR
ORLANDO FL
32824-7362
US

IV. Provider business mailing address

12198 SUMTER DR
ORLANDO FL
32824-7362
US

V. Phone/Fax

Practice location:
  • Phone: 703-850-1019
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: