Basic Information
| Provider Information | |||||||||
| NPI: | 1225477359 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMIR | ||||||||
| FirstName: | MAHSA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 151 SOUTHHALL LN STE 300 | ||||||||
| Address2: | |||||||||
| City: | MAITLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327517172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078752080 | ||||||||
| FaxNumber: | 3033182481 | ||||||||
| Practice Location | |||||||||
| Address1: | 9399 CROWN CREST BLVD STE 400 | ||||||||
| Address2: | |||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801388540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038403311 | ||||||||
| FaxNumber: | 0384014733 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2013 | ||||||||
| LastUpdateDate: | 11/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | DR.0058717 | CO | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.