| Shahul Hameed Riazudeen Md Pa | |
|
16541 S Us Highway 301 Wimauma FL 33598-2032 | |
| (813) 633-1100 | |
| (813) 633-1152 |
| Full Name | Shahul Hameed Riazudeen Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 16541 S Us Highway 301, Wimauma, Florida |
| Authorized Official Name and Position | Shahul Hameed Riazudeen (PRESIDENT) |
| Authorized Official Contact | 8136331100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahul Hameed Riazudeen Md Pa Po Box 5849 Sun City Center FL 33571-5849 Ph: (813) 633-1100 | Shahul Hameed Riazudeen Md Pa 16541 S Us Highway 301 Wimauma FL 33598-2032 Ph: (813) 633-1100 |
| NPI Number | 1144343690 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 04/10/2020 |
| Medicare PECOS PAC ID | 3779676481 |
|---|---|
| Medicare Enrollment ID | O20070911000204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144343690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME93264 (Florida) | Primary |
| Provider Name | Shahul Riazudeen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932163888 PECOS PAC ID: 1759315195 Enrollment ID: I20050924000058 |
| Provider Name | Irena Stefan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871140087 PECOS PAC ID: 9739518309 Enrollment ID: I20200402000088 |
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