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Individual

ITZHAK I SHASHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1201 N OLIVE AVE, WEST PALM BEACH, FL 33401-3515
(561) 655-4334
(561) 655-9449
Mailing address
1 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 844-7000

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0044363
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
069346400
FL
01
1078157
WELLCARE
FL
01
1999249
CIGNA
FL
01
217581
AVMED
FL
01
4008202
AETNA
FL
01
4395
DIMENSION
FL
01
61379
BCBS
FL
01
P01607923
RR MEDICARE
FL
Enumeration date
09/12/2006
Last updated
01/13/2022
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