MEDICARE: SHAHLA GOODARZI AMROOEI ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP1895612	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922089838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAHLA GOODARZI AMROOEI ARNP

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-315-6775
Fax Number	:	813-635-2613

Provider Business Practice Location Address
First Line	:	1919 W SWANN AVE FL 3
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2417
Country	:	US
Telephone Number	:	813-254-8055
Fax Number	:	813-443-8163

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	03/12/2025

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