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1144632217
SOUSAN YAZDI BLACK
FORT MYERS, FL
NPI
1144632217
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Former Name
SOUSAN AKHAVAN YAZDI
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: FL ARNP9293083)
Enumeration Date
2014-05-23
Last Update Date
2014-05-23
Business Address
-- SOUSAN YAZDI BLACK ARNP
8931 COLONIAL CENTER DR SUITE 300
FORT MYERS, FL 33905-7809
Phone number: 239-938-0800
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Mailing Address
-- SOUSAN YAZDI BLACK ARNP
4371 VERONICA S SHOEMAKER BLVD ATTN: CREDENTIALING
FORT MYERS, FL 33916-2216
Phone number: 239-274-8200
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