MEDICARE: MR. MAGED SHALABY

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	183500000X	Pharmacist	047484	NY
2	183500000X	Pharmacist	RPH023796	GA
3	183500000X	Pharmacist	PS43085	FL

General Provider Information

NPI Number	:	1417120205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MAGED SHALABY

Provider Business Mailing Address
First Line	:	340 W 23RD ST STE D2
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4541
Country	:	US
Telephone Number	:	850-615-1000
Fax Number	:	850-215-3344

Provider Business Practice Location Address
First Line	:	340 W 23RD ST STE D2
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4541
Country	:	US
Telephone Number	:	850-615-1000
Fax Number	:	850-215-3344

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

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	11/04/2010

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Directions to “ MR. MAGED SHALABY ” Practice Location

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