Healthcare Provider Details

I. General information

NPI: 1902808298
Provider Name (Legal Business Name): ASHRAF A.H.F. EL-SHALAKANY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 11/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 N UNIVERSITY DR SUITE 420
CORAL SPRINGS FL
33065-1405
US

IV. Provider business mailing address

2855 N UNIVERSITY DR STE 420
CORAL SPRINGS FL
33065-1408
US

V. Phone/Fax

Practice location:
  • Phone: 954-340-5178
  • Fax: 954-340-6732
Mailing address:
  • Phone: 954-340-5178
  • Fax: 954-340-6732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME87739
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME87739
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME87739
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: