Basic Information
| Provider Information | |||||||||
| NPI: | 1780828095 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PASHA | ||||||||
| FirstName: | ARASH | ||||||||
| MiddleName: | GHASSEMI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7075 N US HIGHWAY 1 | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | PORT ST JOHN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329275216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3212686264 | ||||||||
| FaxNumber: | 3212686360 | ||||||||
| Practice Location | |||||||||
| Address1: | 951 N WASHINGTON AVE | ||||||||
| Address2: | PARRISH MEDICAL CENTER. HOSPITALIST DEPT | ||||||||
| City: | TITUSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327962163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3212686111 | ||||||||
| FaxNumber: | 3212686360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2009 | ||||||||
| LastUpdateDate: | 02/05/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD446234 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | ME118166 | FL | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | ME118166 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | ATN 560202 | 05 | FL | MEDICAID |