MEDICARE: SHABNAM ZAHEDI MD

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	207Q00000X	Family Medicine Physician	ME157438	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	:	1861951808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHABNAM ZAHEDI MD

Provider Business Mailing Address
First Line	:	2995 DREW ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-281-9065
Fax Number	:

Provider Business Practice Location Address
First Line	:	3128 E HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4528
Country	:	US
Telephone Number	:	813-579-1769
Fax Number	:	813-305-7907

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

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	06/06/2025

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