Provider Demographics
NPI:1962003178
Name:SHEIKH, MOHAMMED BILAL
Entity Type:Individual
Prefix:MR
First Name:MOHAMMED BILAL
Middle Name:
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BILAL
Other - Middle Name:
Other - Last Name:SHEIKH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:205 NW 128TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1167
Mailing Address - Country:US
Mailing Address - Phone:305-321-7163
Mailing Address - Fax:
Practice Address - Street 1:2920 NE 207TH ST STE 901
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1444
Practice Address - Country:US
Practice Address - Phone:305-321-7163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9112784363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty