Individual
MARYAM TAHMASBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13220 USF LAUREL DR, 5TH FLOOR, TAMPA, FL 33612-4742
(813) 974-0536
(813) 974-5536
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME118009
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021440600
—
FL
01
—
375OF
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/22/2011
Last updated
03/30/2021
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