| Shahla Medical Associates Pa | |
|
1141 Beach Blvd Jacksonville Beach FL 32250-3445 | |
| (904) 249-3820 | |
| (904) 249-3390 |
| Full Name | Shahla Medical Associates Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1141 Beach Blvd, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Sean Shahla (PRESIDENT) |
| Authorized Official Contact | 9042493820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahla Medical Associates Pa 1141 Beach Blvd Jacksonville Beach FL 32250-3445 Ph: (904) 249-3820 | Shahla Medical Associates Pa 1141 Beach Blvd Jacksonville Beach FL 32250-3445 Ph: (904) 249-3820 |
| NPI Number | 1235317397 |
|---|---|
| Provider Enumeration Date | 01/31/2008 |
| Last Update Date | 11/08/2011 |
| Medicare PECOS PAC ID | 3870766819 |
|---|---|
| Medicare Enrollment ID | O20111108000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235317397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Amer Shahla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356339519 PECOS PAC ID: 2567482615 Enrollment ID: I20051203000034 |
| Provider Name | Sean Shahla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801884119 PECOS PAC ID: 2062685977 Enrollment ID: I20111109000064 |
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