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General NPI Number Information
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NPI Number | 1669518320
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Entity Type | Individual
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Provider Name | AYAD SHUKUR MD
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 7975 LAKE UNDERHILL RD STE 240
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City | ORLANDO
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State | FL
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Zip | 32822-8208
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Country | US
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Telephone | 407-265-2042
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Fax | 407-289-5263
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Provider Business Mailing Address
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Address Line | PO BOX 780547
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City | ORLANDO
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State | FL
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Zip | 32878-0547
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Country | US
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Telephone | 407-482-5588
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Fax | 407-358-5084
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 93764
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License Number State | FL
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