MEDICARE: SHERNAUZA MOHAMMED MS-SLP

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	235Z00000X	Speech-Language Pathologist	SA12529	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053625806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERNAUZA MOHAMMED MS-SLP

Provider Business Mailing Address
First Line	:	12091 NW 2ND DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8012
Country	:	US
Telephone Number	:	305-281-5658
Fax Number	:

Provider Business Practice Location Address
First Line	:	12091 NW 2ND DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8012
Country	:	US
Telephone Number	:	305-281-5658
Fax Number	:

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

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	10/07/2022

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