MEDICARE: SHAHID SHAFIQ MALIK 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	207RC0000X	Cardiovascular Disease Physician	ME 47456	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00264250	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1306866058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAHID SHAFIQ MALIK M.D.

Provider Business Mailing Address
First Line	:	17935 CACHET ISLE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2703
Country	:	US
Telephone Number	:	813-633-9700
Fax Number	:	813-633-9733

Provider Business Practice Location Address
First Line	:	733 CORTARO DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33573-6812
Country	:	US
Telephone Number	:	813-633-9700
Fax Number	:	813-633-9733

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	02/20/2015

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