Individual
DR. SHAHLA MASOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP PATHOLOGY DEPT, JACKSONVILLE, FL 32209-6511
(904) 244-4387
(904) 244-4060
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
ME29769
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME29769
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000288175B
—
GA
05
—
0688657-00
—
FL
01
—
220008911
RAILROAD MEDICARE
FL
Enumeration date
03/23/2006
Last updated
07/22/2008
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