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General NPI Number Information
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NPI Number | 1952228421
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Entity Type | Individual
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Provider Name | MRS. ATHAR GHASSEMI BOLOURCHI
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Gender | Female
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Dates
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Enumeration Date | 07/03/2026
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Last Update Date | 07/03/2026
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Provider Practice Location Address
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Address Line | 83 W MILLER ST
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City | ORLANDO
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State | FL
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Zip | 32806-2031
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Country | US
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Telephone | 321-843-9792
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 PALM VISTA DR
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City | APOPKA
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State | FL
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Zip | 32712-2445
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Country | US
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Telephone | 407-547-7745
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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 | 163WS0121X
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Taxonomy Name | Plastic Surgery Registered Nurse
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License Number | 721058
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License Number State | FL
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