Provider Demographics
NPI:1356105019
Name:SHAKIL, SHANILA
Entity type:Individual
Prefix:MS
First Name:SHANILA
Middle Name:
Last Name:SHAKIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 CALLE JOSE FIDALGO DIAZ
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5323
Mailing Address - Country:US
Mailing Address - Phone:787-244-8333
Mailing Address - Fax:
Practice Address - Street 1:4633 AVE ISLA VERDE
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-5300
Practice Address - Country:US
Practice Address - Phone:787-244-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program