Healthcare Provider Details

I. General information

NPI: 1811997422
Provider Name (Legal Business Name): THABET ALSHEIKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 BAPTIST WAY STE 3A
PENSACOLA FL
32503-2274
US

IV. Provider business mailing address

1717 N E ST STE 331
PENSACOLA FL
32501-6335
US

V. Phone/Fax

Practice location:
  • Phone: 448-227-6500
  • Fax: 850-857-1747
Mailing address:
  • Phone: 850-484-6500
  • Fax: 850-857-1747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number31568
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME78624
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: