Healthcare Provider Details

I. General information

NPI: 1275442170
Provider Name (Legal Business Name): SHAUN J ALI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5135 SW 178TH STREET ROAD
OCALA FL
34473
US

IV. Provider business mailing address

2440 NW 22ND CT
OCALA FL
34475-4852
US

V. Phone/Fax

Practice location:
  • Phone: 518-810-4224
  • Fax:
Mailing address:
  • Phone: 518-810-4224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: