Provider Demographics
NPI:1114346285
Name:SHAFIQ, ASIF RAZA (DO)
Entity Type:Individual
Prefix:DR
First Name:ASIF
Middle Name:RAZA
Last Name:SHAFIQ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 49TH ST N STE S201
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2146
Mailing Address - Country:US
Mailing Address - Phone:727-605-1770
Mailing Address - Fax:727-605-1080
Practice Address - Street 1:5800 49TH ST N STE S201
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2146
Practice Address - Country:US
Practice Address - Phone:727-605-1770
Practice Address - Fax:727-605-1080
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17994207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery