Provider Demographics
NPI:1639305972
Name:SHAHEEN, ELIAS IBRAHIM (MD)
Entity type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:IBRAHIM
Last Name:SHAHEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:15455 COLLIER BLVD UNIT 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-7874
Mailing Address - Country:US
Mailing Address - Phone:239-514-2005
Mailing Address - Fax:239-593-0067
Practice Address - Street 1:15455 COLLIER BLVD UNIT 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-7874
Practice Address - Country:US
Practice Address - Phone:239-514-2005
Practice Address - Fax:239-593-0067
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036128436207Q00000X
FLME123307207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine