Provider Demographics
NPI:1124028741
Name:SHAMI SHER, HALLA F (MD)
Entity type:Individual
Prefix:
First Name:HALLA
Middle Name:F
Last Name:SHAMI SHER
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 1:630 VASSAR ST
Mailing Address - Street 2:UNIT #2205
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5363
Mailing Address - Country:US
Mailing Address - Phone:352-205-6341
Mailing Address - Fax:
Practice Address - Street 1:630 VASSAR ST
Practice Address - Street 2:UNIT #2205
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5363
Practice Address - Country:US
Practice Address - Phone:352-205-6341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84167207Y00000X
ND13102207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND18456Medicaid
FL266034200Medicaid
FL06826OtherBCBS
FLH16106Medicare UPIN
FL06826VMedicare PIN
FL266034200Medicaid
NDN719533Medicare PIN
FL06826WMedicare PIN
ND18456Medicaid