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General NPI Number Information
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NPI Number | 1407837784
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Entity Type | Individual
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Provider Name | YASMEEN M ISLAM M.D. PA
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Gender | Female
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 3400 TAMIAMI TRL SUITE 102
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8102
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Country | US
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Telephone | 941-625-5855
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Fax | 941-625-7123
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Provider Business Mailing Address
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Address Line | 3400 TAMIAMI TRL SUITE 102
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8102
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Country | US
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Telephone | 941-625-5855
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Fax | 941-625-7123
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | FLME78276
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License Number State | FL
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