Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ayesha Tabassom

Individual provider Emergency Medicine Physician · NPI 1033558630

Ayesha Tabassom is an Emergency Medicine Physician in Daytona Beach, Florida. Practices as a sole proprietor and works from 3 locations. Licensed in Florida and Louisiana.

Licensed in
FL, LA
In the registry since
2013
Specialties on file
3
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Practice location Address checks out

222 S Peninsula Dr
Daytona Beach, FL 32118-4422
Phone: (386) 310-2160
Fax: (386) 310-2106
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1400 Coleman Ave, Macon, GA 31207-0001 — (478) 301-2604
  • 1541 Kings Hwy, Shreveport, LA 71103-4228 — (318) 626-0000

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence ME166083 (FL)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 312453 (LA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 312453 (LA)

Record details

NPI number1033558630
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 18, 2013
Last updated in NPPESMarch 12, 2025
Certification dateMarch 12, 2025
Mailing address222 S Peninsula Dr, Daytona Beach, FL 32118-4422

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