YERVANT KHATCHERIAN MD PA
Ambulatory Health at Us Highway 19, Clearwater, FL

License number
Florida ME75296
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: DR. YERVANT KHATCHERIAN MD
Title: PRESIDENT
Phone: (727) 771-8444
Address
Address
29605 Us Highway 19 N SUITE 170, Clearwater, FL 33761
National Provider ID: 1023332905
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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YERVANT KHATCHERIAN, M.D., PA

3104 Masters Dr, Clearwater, FL 33761

Status:
Inactive
Inactive reason:
REINSTATEMENT
Registration:
Aug 15, 2000
Inactive since:
Feb 6, 2011
State ID:
P00000079102
Business type:
Florida Profit Corporation
Yervant A Khatcherian, 3104 Masters Dr, Clearwater, FL 33761 (Physical)
Agent:
Walter Blenner,2708 Alt 19 N SUITE 701, Palm Harbor, FL 34683 (Physical)
FEI/EIN:
593666207

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