Provider Demographics
NPI:1699835686
Name:SHINGALA, ASHVIN (MD)
Entity Type:Individual
Prefix:
First Name:ASHVIN
Middle Name:
Last Name:SHINGALA
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 1:2204 S PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-5212
Mailing Address - Country:US
Mailing Address - Phone:813-684-3222
Mailing Address - Fax:
Practice Address - Street 1:2204 S PARSONS AVE
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-5212
Practice Address - Country:US
Practice Address - Phone:813-684-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84398207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263805300Medicaid
FL15497OtherBCBS PROVIDER NUMBER
FL263805300Medicaid
FL15497ZMedicare PIN