Provider Demographics
NPI:1467466219
Name:SHAFII, SOHRAB (MD)
Entity Type:Individual
Prefix:
First Name:SOHRAB
Middle Name:
Last Name:SHAFII
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 W BUSCH BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7603
Mailing Address - Country:US
Mailing Address - Phone:813-684-2229
Mailing Address - Fax:813-413-8516
Practice Address - Street 1:1513 W BUSCH BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7603
Practice Address - Country:US
Practice Address - Phone:813-684-2229
Practice Address - Fax:813-413-8516
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME28697207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00656OtherWELLCARE
FL039228600Medicaid
233593OtherAVMED
160000216OtherRAILROAD MEDICARE
FL30296OtherBLUE CROSS BLUE SHIELD
FL039228600Medicaid
D53933Medicare UPIN