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General NPI Number Information
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NPI Number | 1073405304
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Entity Type | Organization
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Legal Business Name | SHAZIA BASHIR MD PLLC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 1680 OSCEOLA ELEMENTARY RD STE A
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-5942
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Country | US
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Telephone | 314-479-9243
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Fax |
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Provider Business Mailing Address
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Address Line | 707 1ST ST S APT 604
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-6670
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Country | US
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Telephone | 314-479-9243
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Fax |
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Authorized Official
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Title or Position | OWNER AND CEO
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Name | DR. SHAZIA BASHIR
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Credential | MD, MPH
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Telephone | 314-479-9243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State |
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