MEDICARE: DR. SHARAB MOHAMED M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME00064608	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0402795	OTHER	FL	UNITED HEALTH CARE ID
2	33186	OTHER	FL	BCBS GROUP ID
3	650518562	OTHER	FL	VISTA HEALTH CARE ID
4	650518562	OTHER	FL	FED ID FOR ALL OTHER COMM
5	241798	OTHER	FL	AVMED INDIVIDUAL ID
6	650518562	OTHER	FL	GHI INSURANCE ID
7	964625	OTHER	FL	AETNA HEALTH INSURANCE ID
8	23558	OTHER	FL	BLUE CROSS BLUE SHIELD ID
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	650518562	OTHER	FL	TOTAL HEALTH CHOICE ID
11	650518562	OTHER	FL	CHAMPUS ID
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033210893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARAB MOHAMED M.D.

Provider Business Mailing Address
First Line	:	3345 JOG RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-2010
Country	:	US
Telephone Number	:	561-965-0813
Fax Number	:	561-965-7505

Provider Business Practice Location Address
First Line	:	3345 JOG RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-2010
Country	:	US
Telephone Number	:	561-965-0813
Fax Number	:	561-965-7505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	06/17/2011

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