Provider Demographics
NPI:1083346449
Name:YASSINE, NOOR (DO)
Entity type:Individual
Prefix:
First Name:NOOR
Middle Name:
Last Name:YASSINE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12730 NEW BRITTANY BLVD STE 602
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-4690
Mailing Address - Country:US
Mailing Address - Phone:239-275-5522
Mailing Address - Fax:
Practice Address - Street 1:13195 METRO PKWY STE 8
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-4810
Practice Address - Country:US
Practice Address - Phone:239-482-1010
Practice Address - Fax:239-938-7174
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-25
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS21921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty