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General NPI Number Information
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NPI Number | 1912215179
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Entity Type | Individual
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Provider Name | MAHSHID N/A ROOHI NP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 3300 W LAKE MARY BLVD STE 100 NEMOURS CHILDRENS SPECIALTY CARE, LAKE MARY
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City | LAKE MARY
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State | FL
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Zip | 32746-3499
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Country | US
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Telephone | 407-567-4000
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Fax | 407-567-5924
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Provider Business Mailing Address
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Address Line | PO BOX 191 PROVIDER ENROLLMENT DEPARTMENT
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City | ROCKLAND
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State | DE
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Zip | 19732-0191
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Country | US
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Telephone | 302-651-6212
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Fax | 302-651-4945
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9391935
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | CNP-O1664
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9391935
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License Number State | FL
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