1902808298 NPI number — DR. ASHRAF A.H.F. EL-SHALAKANY M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902808298 NPI number — DR. ASHRAF A.H.F. EL-SHALAKANY M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

EL-SHALAKANY

Provider First Name:

ASHRAF

Provider Middle Name:

A.H.F.

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1902808298

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/27/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2855 N UNIVERSITY DR STE 420

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

CORAL SPRINGS

Provider Business Mailing Address State Name:

FL

Provider Business Mailing Address Postal Code:

33065-1408

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

954-340-5178

Provider Business Mailing Address Fax Number:

954-340-6732

Provider First Line Business Practice Location Address:

2855 N UNIVERSITY DR

Provider Second Line Business Practice Location Address:

SUITE 420

Provider Business Practice Location Address City Name:

CORAL SPRINGS

Provider Business Practice Location Address State Name:

FL

Provider Business Practice Location Address Postal Code:

33065-1405

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

954-340-5178

Provider Business Practice Location Address Fax Number:

954-340-6732

Provider Enumeration Date:

06/01/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207RC0001X , with the licence number:  ME87739 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RI0011X , with the licence number: ME87739 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RC0000X , with the licence number: ME87739 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 2038881 . This is a "CIGNA PROV ID #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 78940 . This is a "BCBS OF FL PROV ID #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 267318500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
• Identifier: 271070 . This is a "AMERIGROUP MCD PROV ID #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 7619486 . This is a "AETNA PROV ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 1085239 . This is a "HUMANA PROV ID #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 17698 . This is a "FHHS PROV ID #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 2297311 . This is a "UNITED H'CARE PROV ID #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 117012300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".