Provider Demographics
NPI:1841283728
Name:NOROOZI, SHEILA (D P M)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:NOROOZI
Suffix:
Gender:F
Credentials:D P M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 SE 3RD CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0444
Mailing Address - Country:US
Mailing Address - Phone:352-867-0024
Mailing Address - Fax:352-867-0029
Practice Address - Street 1:2825 SE 3RD CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0444
Practice Address - Country:US
Practice Address - Phone:352-867-0024
Practice Address - Fax:352-867-0029
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3155213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340473100Medicaid
FL340473100Medicaid
FL5897830001Medicare NSC
FLU91799Medicare UPIN