Provider Demographics
NPI:1821108440
Name:SHAIKH, RIZWANA SHAHEEN (MD)
Entity Type:Individual
Prefix:
First Name:RIZWANA
Middle Name:SHAHEEN
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12781 MIRAMAR PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2906
Mailing Address - Country:US
Mailing Address - Phone:954-437-2020
Mailing Address - Fax:954-436-9614
Practice Address - Street 1:12781 MIRAMAR PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2906
Practice Address - Country:US
Practice Address - Phone:954-437-2020
Practice Address - Fax:954-436-9614
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83620207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
651066060OtherEIN
H69864Medicare UPIN
FLE8047AMedicare ID - Type Unspecified