MEDICARE: MOHAMED SHAALAN 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	208M00000X	Hospitalist Physician	ME89911	FL
2	207R00000X	Internal Medicine Physician	ME89911	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	:	1235103912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED SHAALAN M.D.

Provider Business Mailing Address
First Line	:	6817 SOUTHPOINT PKWY STE 1602
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6298
Country	:	US
Telephone Number	:	904-902-0091
Fax Number	:	904-600-5299

Provider Business Practice Location Address
First Line	:	6817 SOUTHPOINT PKWY STE 1602
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6298
Country	:	US
Telephone Number	:	904-902-0091
Fax Number	:	904-600-5299

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	03/10/2026

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