Provider Demographics
NPI:1346135068
Name:AZIZ, JOHN ASHRAF (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ASHRAF
Last Name:AZIZ
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-7706
Mailing Address - Country:US
Mailing Address - Phone:352-284-3910
Mailing Address - Fax:
Practice Address - Street 1:470 PHEASANT DR
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-7706
Practice Address - Country:US
Practice Address - Phone:352-284-3910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11040130363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health