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General NPI Number Information
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NPI Number | 1336146133
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Entity Type | Individual
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Provider Name | AFSHIN NOORI PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 13020 N TELECOM PKWY
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City | TEMPLE TERRACE
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State | FL
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Zip | 33637-0915
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Country | US
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Telephone | 813-978-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 13020 N TELECOM PKWY
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City | TEMPLE TERRACE
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State | FL
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Zip | 33637-0925
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Country | US
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Telephone | 813-978-9700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 12135
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA 9105995
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License Number State | FL
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