Provider Demographics
NPI:1972387371
Name:RAHMAN, SANAH (PA-C)
Entity type:Individual
Prefix:
First Name:SANAH
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N FRANKLIN ST UNIT 1805
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3879
Mailing Address - Country:US
Mailing Address - Phone:281-854-9668
Mailing Address - Fax:
Practice Address - Street 1:915 N FRANKLIN ST UNIT 1805
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3879
Practice Address - Country:US
Practice Address - Phone:281-854-9668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117733363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical