Healthcare Provider Details

I. General information

NPI: 1356478663
Provider Name (Legal Business Name): AMMAR SHAMMAA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11175 COUNTY LINE RD
SPRING HILL FL
34609-5615
US

IV. Provider business mailing address

PO BOX 1289
TAMPA FL
33601-1289
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-8888
  • Fax: 352-684-6888
Mailing address:
  • Phone: 352-686-8888
  • Fax: 352-684-6888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME172604
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number22915
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: