Individual
SHOHREH IRAVANI DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12902 MAGNOLIA DRIVE, TAMPA, FL 33612
(813) 745-3587
(813) 745-4226
Mailing address
12902 MAGNOLIA DRIVE, TAMPA, FL 33612
(888) 860-2778
(813) 745-4226
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME67299
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277872600
—
FL
Enumeration date
03/30/2007
Last updated
10/29/2008
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