SOUSAN YAZDI BLACK


Address: 8931 Colonial Center Dr, Suite 300, Fort Myers, FL 33905-7809
Phone: 2399380800

SOUSAN YAZDI BLACK (NPI# 1144632217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144632217
Entity Type Individual
Full Name SOUSAN YAZDI BLACK
Other Name SOUSAN AKHAVAN YAZDI
Credential ARNP
Practice Address 8931 Colonial Center Dr
Suite 300
Fort Myers
FL 33905-7809
Mailing Address 4371 Veronica S Shoemaker Blvd
Attn: Credentialing
Fort Myers
FL 33916-2216
Practice Telephone 2399380800
Practice Fax Number 2399380890
Mailing Telephone 2392748200
Mailing Fax Number 2392783350
Enumeration Date 2014-05-23
Last Update Date 2014-05-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
ARNP9293083 FL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 8931 COLONIAL CENTER DR
SUITE 300
City FORT MYERS
State FL
Zip Code 33905-7809

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306843370 James W. Orr Jr. Obstetrics & Gynecology 8931 Colonial Center Dr, Suite 400, Fort Myers, FL 33905-7816 2005-07-05
1457833196 Jessica Isaacs Genetic Counselor, MS 8931 Colonial Center Dr, Fort Myers, FL 33905-7809 2018-08-29
1902291263 Keisha Miller Nurse Practitioner 8931 Colonial Center Dr, Suite100, Fort Myers, FL 33905-7809 2015-04-03
1053703454 21st Century Oncology LLC Urology 8931 Colonial Center Dr, Suite 100, Fort Myers, FL 33905-7809 2015-02-23
1396134961 Christina Clark Physician Assistant 8931 Colonial Center Dr, Suite 301, Fort Myers, FL 33905-7809 2015-01-20
1912303389 Gabriella Brock Pharmacist 8931 Colonial Center Dr, Suite 200, Fort Myers, FL 33905-7809 2014-11-13
1447650270 Kristen Marlene Kirdahy Pharmacist 8931 Colonial Center Dr, Suite 200 - Pharmacy, Fort Myers, FL 33905-7809 2014-08-29
1841614237 Ma Antonietta Orlang Registered Nurse 8931 Colonial Center Dr, Suite 302, Fort Myers, FL 33905-7809 2014-02-06
1073864526 Michael David Cook Physician Assistant 8931 Colonial Center Dr, Suite 100, Fort Myers, FL 33905-7809 2012-09-24
1518215862 Jenna Dees Thibodeau Physician Assistant 8931 Colonial Center Dr, #300, Fort Myers, FL 33905-7816 2012-08-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1811476211 Lisa Nicole Campbell Nurse Practitioner 2850 Via Campania St, Fort Myers, FL 33905 2018-08-07
1538670260 Doctorguarin LLC Clinic/Center 3143 Antica St, Fort Myers, FL 33905 2017-10-20
1366828931 Dawn Bradley Arnp Pllc Nurse Practitioner 3056 Champion Ring Rd, Ft Myers, FL 33905 2015-08-06
1720480551 Yohana Pierre Villarroel Licensed Practical Nurse 2789 Ortiz Ave., Fort Myers, FL 33905 2014-09-24
1639592090 Hamprenate Service Case Manager/Care Coordinator 2789 Oritz Avenue, Fort Myere, FL 33905 2014-01-21
1255688743 Ronak B Patel Pharmacist 9365 Via Murano Ct, Fort Myers, FL 33905 2012-08-14
1477824852 Joseph Francis Kusiak Plastic Surgery 3320 Shady Bend, Fort Myers, FL 33905 2012-01-18
1336447838 Vicky Brooks Nurse Practitioner 8960 Colonial Center Dr Ste 300, Fort Myers, FL 33905 2011-03-08
1790898666 Access Medical South, Lc Durable Medical Equipment & Medical Supplies 5701 Country Lakes Dr., Suite 20, Ft. Myers, FL 33905 2006-08-16
1780691600 Arthur Lee Strauss Social Worker 6000 South Dixie Hwy, Suite B, West Palm Beach, FL 33905 2006-08-02
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700341450 Kimberly Debow Nurse Practitioner 14646 Aeries Way Dr, Fort Myers, FL 33912-1703 2019-02-06
1144704917 Adelene Frances Tolisano Nurse Practitioner 6840 Fairview St, Fort Myers, FL 33966-1133 2018-09-18
1215417951 Doreen Destefano Nurse Practitioner 12734 Kenwood Ln Ste 84, Fort Myers, FL 33907-5638 2018-08-21
1467943803 Marie Veronica Scott Nurse Practitioner 14015 Danpak Loop, Fort Myers, FL 33912 2018-05-22
1891127791 Kimberly A. Litka Nurse Practitioner 6150 Diamond Centre Ct Unit 400, Fort Myers, FL 33912-4367 2013-08-01
1336447838 Vicky Brooks Nurse Practitioner 8960 Colonial Center Dr Ste 300, Fort Myers, FL 33905 2011-03-08
1376694778 Melanie Makar Nurse Practitioner 1390 Royal Palm Square Blvd, Fort Myers, FL 33919-1077 2007-01-15
1598814972 Deborah Wince Chapa Nurse Practitioner 8925 Colonial Center Drive, Suite 1000, Fort Myers, FL 33905-7810 2007-01-09
1316048895 Laurie Haefele Nurse Practitioner 11215 Metro Pkwy, Fort Myers, FL 33966-1206 2006-09-26
1457451130 Jo Anne Theresa Kowalski Nurse Practitioner 17050 Coral Cay Ln, Fort Myers, FL 33908-5073 2006-09-23
Find all providers in FORT MYERS

Competitor

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City FORT MYERS
Zip Code 33905

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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