MEDICARE: DR. MAE SHEIKH-ALI 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME93580	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
2	28675	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164405122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAE SHEIKH-ALI M.D.

Provider Business Mailing Address
First Line	:	14286 BEACH BLVD STE 19-208
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32250-1561
Country	:	US
Telephone Number	:	610-529-4165
Fax Number	:	904-281-9806

Provider Business Practice Location Address
First Line	:	3627 UNIVERSITY BLVD S STE 310
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4294
Country	:	US
Telephone Number	:	610-529-4165
Fax Number	:	904-281-9806

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	11/29/2023

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Directions to “ DR. MAE SHEIKH-ALI M.D.” Practice Location

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