Healthcare Provider Details

I. General information

NPI: 1649585944
Provider Name (Legal Business Name): SHAHEEN EMMANUEL LAKHAN MD, PHD, FAAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 BRICKELL AVE UNIT 3018
MIAMI FL
33131
US

IV. Provider business mailing address

1050 BRICKELL AVE UNIT 3018
MIAMI FL
33131
US

V. Phone/Fax

Practice location:
  • Phone: 818-574-3062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301508015
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberC3081
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101263215
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35.120308
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME152534
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberME152534
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME152534
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: