Provider Demographics
NPI:1184836850
Name:JUNEJO, SHAKRA Z (MD)
Entity Type:Individual
Prefix:
First Name:SHAKRA
Middle Name:Z
Last Name:JUNEJO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 ROYAL ISLE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-4257
Mailing Address - Country:US
Mailing Address - Phone:850-878-4979
Mailing Address - Fax:
Practice Address - Street 1:2551 EXECUTIVE CENTER CIRCLE DRIVE
Practice Address - Street 2:LAFAYETTE BUILDING, SUITE 200
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32399-6512
Practice Address - Country:US
Practice Address - Phone:850-487-1491
Practice Address - Fax:850-413-9699
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 43969207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine