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General NPI Number Information
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NPI Number | 1366001224
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Entity Type | Organization
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Legal Business Name | SHAH SHAREEF, D.O., LLC
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 5741 BEE RIDGE RD STE 570
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City | SARASOTA
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State | FL
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Zip | 34233-5080
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Country | US
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Telephone | 941-203-8757
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Fax | 941-552-8647
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Provider Business Mailing Address
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Address Line | 5741 BEE RIDGE RD STE 570
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City | SARASOTA
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State | FL
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Zip | 34233-5080
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Country | US
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Telephone | 941-203-8757
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Fax | 941-552-8647
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Authorized Official
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Title or Position | AMBR
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Name | SHAHJAHAN SHAREEF
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Credential | D.O.
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Telephone | 772-240-9190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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