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General NPI Number Information
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NPI Number | 1730684424
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Entity Type | Individual
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Provider Name | ISLAM GANIE APRN FNP-BC PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 6613 49TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-5728
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Country | US
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Telephone | 727-954-4543
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Fax |
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Provider Business Mailing Address
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Address Line | 4056 38TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33713-1233
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Country | US
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Telephone | 301-323-3166
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9303864
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN9303864
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License Number State | FL
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