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NPI Code Detail

MEDICARE: SHAH HOSEIN PA-C

MEDICARE: SHAH HOSEIN PA-C
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
1363AS0400XSurgical Physician AssistantPA9104459FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548237662
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAH HOSEIN PA-C
Provider Business Mailing Address
First Line : 1001 NW 13TH ST STE 201
Second Line :
City : BOCA RATON
State : FL
Zip : 33486-2269
Country : US
Telephone Number : 561-955-6663
Fax Number : 561-955-2879
Provider Business Practice Location Address
First Line : 2815 S SEACREST BLVD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33435-7969
Country : US
Telephone Number : 561-737-7733
Fax Number : 561-733-5192
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 05/27/2022

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Directions to “ SHAH HOSEIN PA-C” Practice Location

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