Provider Demographics
NPI:1740335264
Name:ARANKE, SHACHIE V (MD)
Entity type:Individual
Prefix:
First Name:SHACHIE
Middle Name:V
Last Name:ARANKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP PROVIDER ENROLLMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:580 W 8TH ST
Practice Address - Street 2:UFJP NEUROLOGY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6533
Practice Address - Country:US
Practice Address - Phone:904-244-3960
Practice Address - Fax:904-244-9493
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN177262084N0400X
MI43010897112084N0400X
FLME1056002084N0400X
GA644972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0014692-00Medicaid
GA419749067AMedicaid
FLCP951ZMedicaid