Healthcare Provider Details

I. General information

NPI: 1275553398
Provider Name (Legal Business Name): MUHAMMAD K SHAUKAT M.D., F.C.C.P
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 N CENTRAL AVE
KISSIMMEE FL
34741-4405
US

IV. Provider business mailing address

1580 SANTA BARBARA BLVD
THE VILLAGES FL
32159-6827
US

V. Phone/Fax

Practice location:
  • Phone: 407-944-3500
  • Fax: 407-944-3503
Mailing address:
  • Phone: 352-259-2159
  • Fax: 352-259-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME49612
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License NumberHCO ID #488456
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: