Provider Demographics
NPI:1598715229
Name:SHAQAREQ, RAMZI M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMZI
Middle Name:M
Last Name:SHAQAREQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 WHETSTONE PL
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5774
Mailing Address - Country:US
Mailing Address - Phone:904-819-6800
Mailing Address - Fax:904-819-6700
Practice Address - Street 1:100 WHETSTONE PL
Practice Address - Street 2:SUITE 208
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5774
Practice Address - Country:US
Practice Address - Phone:904-819-6800
Practice Address - Fax:904-819-6700
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME91451207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272824900Medicaid
FLI30180Medicare UPIN
FLU4798AMedicare PIN