Provider Demographics
NPI:1558376277
Name:SHAIKH, SHAUKAT IBRAHIM (MD)
Entity Type:Individual
Prefix:
First Name:SHAUKAT
Middle Name:IBRAHIM
Last Name:SHAIKH
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 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:ATTN: CREDENTIAL DEPARTMENT
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:400 PINELLAS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3312
Practice Address - Country:US
Practice Address - Phone:727-447-8100
Practice Address - Fax:727-461-2603
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28515207R00000X, 207RH0003X
FLME97011207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277559000Medicaid
FLP00663690OtherRR MCR
FLAG043YMedicare PIN