Magnolia Plastic Surgery Center, LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

OS11384 Issued in FL

Legal business name

MAGNOLIA PLASTIC SURGERY CENTER, LLC

Practice address

2404 Creel LN
Wesley Chapel, FL 33544-4606

Phone

(813) 977-3400

Fax

(330) 773-3698

NPI assigned

Jun 23, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anahita Azharian, DO

Title

Owner

Phone

(813) 977-3400

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1114332780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 CREEL LN",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335444606",
            "telephone_number": "813-977-3400",
            "fax_number": "330-773-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 CREEL LN",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335444606",
            "telephone_number": "813-977-3400",
            "fax_number": "330-773-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PLASTIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "AZHARIAN",
        "authorized_official_first_name": "ANAHITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-977-3400",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "OS11384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Carlysle Maclea IV, ATC
• Crystal Macritchie, CRYSTAL MACRITCHIE
• Kevin Madden, PHARMD
• Lily Dianne Madden
• Sasha Marie Madden, ARNP, NP-C
• Glenda Magrinat, RBT
• Arianna Magrino
• Francis Florianne Roque Maguire, D.M.D
• Vanita Mahan, ARNP
• Allyson Mahendranath

• Plastic Surgery Physician in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.