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General NPI Number Information
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NPI Number | 1356638811
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Entity Type | Individual
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Provider Name | MEHDI SHAMLOO MD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 5000-4 NORWOOD AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32208-5001
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Country | US
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Telephone | 904-869-4257
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Fax | 855-576-4105
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 888-987-1151
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01077867A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 19520
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME169983
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 84493
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License Number State | WI
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