Healthcare Provider Details

I. General information

NPI: 1164405122
Provider Name (Legal Business Name): MAE SHEIKH-ALI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3627 UNIVERSITY BLVD S STE 310
JACKSONVILLE FL
32216-4294
US

IV. Provider business mailing address

14286 BEACH BLVD STE 19-208
JACKSONVILLE FL
32250-1561
US

V. Phone/Fax

Practice location:
  • Phone: 610-529-4165
  • Fax: 904-281-9806
Mailing address:
  • Phone: 610-529-4165
  • Fax: 904-281-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME93580
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: