=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295528321
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARIAN EMAM
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2025
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7505 GRAND LELY DRIVE
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34113-1753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-920-4523
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13103 PINEY MEETINGHOUSE RD
-----------------------------------------------------
City | POTOMAC
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20854-6350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-750-8679
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | DN30670
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------