Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME147161 | FL |
NPI | 1013304039 |
---|---|
Provider Name | Dr. Ihsan Yassine |
First Address | Stuart, FL 34994-4512 |
Second Address | Stuart, FL 34994-4512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2015 |
Last Update Date | 08/12/2020 |