Individual
SHADI AYYOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 HEALTH PARK BLVD STE 300, ST AUGUSTINE, FL 32086-5784
(904) 819-4082
(904) 819-5156
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 819-4082
(904) 819-5156
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37193
AZ
207R00000X
Internal Medicine Physician
44249
TN
208M00000X
Hospitalist Physician
Primary
ME119332
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277141
—
AZ
Enumeration date
04/02/2007
Last updated
03/17/2018
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