Provider Demographics
NPI:1407376155
Name:GRIFFIN, YIFAN MENG (MD)
Entity type:Individual
Prefix:
First Name:YIFAN
Middle Name:MENG
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YIFAN
Other - Middle Name:
Other - Last Name:MENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4712 N ARMENIA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2611
Mailing Address - Country:US
Mailing Address - Phone:813-874-7500
Mailing Address - Fax:813-872-0955
Practice Address - Street 1:4712 N ARMENIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2611
Practice Address - Country:US
Practice Address - Phone:813-874-7500
Practice Address - Fax:813-872-0955
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017019494208800000X
IN01087942A208800000X
FLME1664942088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN064740069OtherMEDICARE PTAN
IN300063508Medicaid