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General NPI Number Information
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NPI Number | 1528152188
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Entity Type | Individual
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Provider Name | SHAKIRA HUSAIN MD
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 100 WHETSTONE PL STE 206
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5774
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Country | US
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Telephone | 904-217-3545
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Fax | 904-562-3282
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Provider Business Mailing Address
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Address Line | 100 WHETSTONE PL SUITE 206
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5774
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Country | US
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Telephone | 904-296-1160
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Fax | 904-483-5852
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME68353
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License Number State | FL
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