Provider Demographics
NPI:1821201567
Name:SHAIKH, NASRIN
Entity Type:Individual
Prefix:MS
First Name:NASRIN
Middle Name:
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NASRIN
Other - Middle Name:
Other - Last Name:BAHRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:258 HANGING MOSS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-6246
Mailing Address - Country:US
Mailing Address - Phone:407-760-9334
Mailing Address - Fax:
Practice Address - Street 1:911 N SPRING GARDEN AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-2560
Practice Address - Country:US
Practice Address - Phone:386-736-3108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6970235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1831263482OtherWHOLE SUM THERAPY