Individual
YAZAN MAZEN SURADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2 TAMPA GENERAL CIR FL CIR2, TAMPA, FL 33606-3603
(813) 396-9478
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
(813) 974-2201
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
ME120537
FL
2084N0400X
Neurology Physician
19223
NH
2084N0400X
Neurology Physician
4301116531
MI
2084N0400X
Neurology Physician
ME120537
FL
2084N0400X
Neurology Physician
Primary
TM00784
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018079600
—
FL
05
—
3118015
—
NH
01
—
GW89I
BLUE CROSS AND BLUE SHIELD
FL
Enumeration date
03/25/2011
Last updated
03/13/2026
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