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NPI Code Detail

MEDICARE: AHVA YASNA ZADEH

MEDICARE: AHVA YASNA ZADEH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1790624575
Entity Type Code : Individual
Provider Name (Legal Business Name) : AHVA YASNA ZADEH
Provider Business Mailing Address
First Line : 318 STONEBROOK FARM WAY
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-6069
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3501 JOHNSON ST # 3
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-5421
Country : US
Telephone Number : 864-551-6820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2026
Last Update Date : 03/26/2026

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Directions to “ AHVA YASNA ZADEH ” Practice Location

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