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General NPI Number Information
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NPI Number | 1346589884
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Entity Type | Individual
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Provider Name | AMJAD A SHAIKH PA
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Gender | Male
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 450 W SR 434 STE 3010
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City | LONGWOOD
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State | FL
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Zip | 32750-5196
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Country | US
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Telephone | 407-767-8200
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Fax | 407-339-1200
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Provider Business Mailing Address
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Address Line | 450 W SR 434 STE 3010
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City | LONGWOOD
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State | FL
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Zip | 32750-5196
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Country | US
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Telephone | 407-767-8200
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Fax | 407-339-1200
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PAT9107093
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License Number State | FL
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