MEDICARE: SHAHINA JAVEED MD PA

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	ME0070915	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1457354474	OTHER	FL	INDIVIDUAL NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275785776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAHINA JAVEED MD PA

Provider Business Mailing Address
First Line	:	4904 MOOG RD
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34690-1857
Country	:	US
Telephone Number	:	727-934-5765
Fax Number	:	727-943-0486

Provider Business Practice Location Address
First Line	:	4904 MOOG RD
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34690-1857
Country	:	US
Telephone Number	:	727-934-5765
Fax Number	:	727-943-0486

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. DEBRA K KLEINSCHMIDT
Credential	:
Telephone Number	:	727-934-5765

Provider Enumeration Date	:	10/15/2008
Last Update Date	:	02/19/2009

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1457354474 — DR. SHAHINA JAVEED MD
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4904 MOOG RD
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Directions to “SHAHINA JAVEED MD PA ” Practice Location

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