Provider Demographics
NPI:1760030282
Name:AHMEDALY, SHIMA
Entity Type:Individual
Prefix:
First Name:SHIMA
Middle Name:
Last Name:AHMEDALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7495 ATLANTIC AVE STE 200-351
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1393
Mailing Address - Country:US
Mailing Address - Phone:954-418-2984
Mailing Address - Fax:
Practice Address - Street 1:16170 ROSECROFT TER
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-9587
Practice Address - Country:US
Practice Address - Phone:954-418-2984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical