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General NPI Number Information
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NPI Number | 1205550068
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Entity Type | Individual
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Provider Name | SUHAA SHAFI PA
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Gender | Female
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 902 CLINT MOORE RD
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City | BOCA RATON
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State | FL
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Zip | 33487-2800
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Country | US
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Telephone | 561-241-6676
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 PASSION FLOWER LN
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City | ALLENTOWN
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State | PA
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Zip | 18104-8230
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Country | US
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Telephone | 610-297-5152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1181287
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License Number State | PA
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