Provider Demographics
NPI:1669411740
Name:ALSHAAR, AYHAM (MD)
Entity type:Individual
Prefix:DR
First Name:AYHAM
Middle Name:
Last Name:ALSHAAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:12900 CORTEZ BLVD STE 203
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-4898
Practice Address - Country:US
Practice Address - Phone:352-597-4499
Practice Address - Fax:352-596-1191
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72909207KA0200X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42349OtherBLUE CROSS BLUE SHIELD
FL253206900Medicaid
FL42349YMedicare PIN
FL42349XMedicare PIN