| Syed Shafeeq Ur Rahman Pa | |
|
805 Virginia Ave Suite 16 Fort Pierce FL 34982-5881 | |
| (772) 468-6969 | |
| (772) 465-5160 |
| Full Name | Syed Shafeeq Ur Rahman Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 805 Virginia Ave, Fort Pierce, Florida |
| Authorized Official Name and Position | Syed Shafeeq Ur Rahman (M.D.) |
| Authorized Official Contact | 7724686969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Syed Shafeeq Ur Rahman Pa 805 Virginia Ave Suite 16 Fort Pierce FL 34982-5881 Ph: (772) 468-6969 | Syed Shafeeq Ur Rahman Pa 805 Virginia Ave Suite 16 Fort Pierce FL 34982-5881 Ph: (772) 468-6969 |
| NPI Number | 1821233305 |
|---|---|
| Provider Enumeration Date | 12/11/2008 |
| Last Update Date | 07/02/2009 |
| Medicare PECOS PAC ID | 0941346720 |
|---|---|
| Medicare Enrollment ID | O20091008000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821233305 | NPI | - | NPPES |
| 260888000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | ME86628 (Florida) | Primary |
| Provider Name | Syed Shafeeq Ur Rahman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518028679 PECOS PAC ID: 6507902384 Enrollment ID: I20091008000185 |
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