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Organization
SHAHLA MEDICAL GROUP, PA
Active
Organization
SHAHLA MEDICAL GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZIAD SHAHLA MD (PRESIDENT)
(239) 948-3444
Entity
Organization
Contact information
Practice address
8800 TERRENE CT STE 102, BONITA SPRINGS, FL 34135-9900
(239) 948-3444
(239) 948-9028
Mailing address
8800 TERRENE CT STE 102, BONITA SPRINGS, FL 34135-9900
(239) 948-3444
(239) 948-9028
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0066854
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110188758
RAILROAD MEDICARE
FL
01
—
26304
BC
FL
05
—
N/A
—
FL
Enumeration date
06/26/2006
Last updated
08/01/2011
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