Provider Demographics
NPI:1962251405
Name:ABDEL MASIH, MARY AYAAD KALDAS (APRN MSN FNP-BC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:AYAAD KALDAS
Last Name:ABDEL MASIH
Suffix:
Gender:
Credentials:APRN MSN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-7115
Mailing Address - Country:US
Mailing Address - Phone:941-927-1234
Mailing Address - Fax:941-921-0043
Practice Address - Street 1:2830 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-7115
Practice Address - Country:US
Practice Address - Phone:419-271-2349
Practice Address - Fax:941-921-0043
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily