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SHAFA CLINIC NPI 1407889629


NPI Information

NPI: 1407889629
Provider Name: SHAFA CLINIC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
609 5TH ST SW
SUITE #3
LIVE OAK, FL
ZIP 32064
Phone: (386) 362-6405
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SHAFA CLINIC is a specialist in Live Oak, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SHAFA CLINIC NPI is 1407889629. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

609 5TH ST SW
SUITE #3
LIVE OAK, FL
ZIP 32064-216
Phone: (386) 362-6405
Fax: (386) 362-6403

The provider's authorized official is Zahoor A Waseem .
The authorized official title is Physician and has the following contact phone number (386) 362-6405.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 7/10/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistME73901FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11558303818OTHERFLORIDAWASEEM NPI
2G65979MEDICARE UPINFLORIDA
3E0381YMEDICARE ID-TYPE UNSPECIFIEDFLORIDAMEDICAREDR W
4E0381BMEDICARE ID-TYPE UNSPECIFIEDFLORIDA
5108993MEDICARE ID-TYPE UNSPECIFIEDFLORIDARIVERBEND
61194811893OTHERFLORIDADANA NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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