Provider Demographics
NPI:1205043593
Name:AL-SHURA, ANIKA NIAMBI (MSOM/PHD)
Entity type:Individual
Prefix:DR
First Name:ANIKA
Middle Name:NIAMBI
Last Name:AL-SHURA
Suffix:
Gender:F
Credentials:MSOM/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W BAY DR STE 607
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3268
Mailing Address - Country:US
Mailing Address - Phone:727-290-8904
Mailing Address - Fax:
Practice Address - Street 1:801 W BAY DR STE 607
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3268
Practice Address - Country:US
Practice Address - Phone:727-290-8904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246RP1900X, 246R00000X
246QH0000X, 246W00000X, 261QH0100X, 246RM2200X, 171400000X, 174H00000X, 235500000X, 261QR1100X, 3747A0650X, 376K00000X, 171100000X
FL31298174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No246QH0000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyHematologyGroup - Multi-Specialty
No246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Pathology
No246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory
No171400000XOther Service ProvidersHealth & Wellness Coach
No174400000XOther Service ProvidersSpecialist
No174H00000XOther Service ProvidersHealth Educator
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376K00000XNursing Service Related ProvidersNurse's Aide