Provider Demographics
NPI:1073264347
Name:SHAHLAMIAN, MEGAN LEIGH (APRN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEIGH
Last Name:SHAHLAMIAN
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1980 N ATLANTIC AVE STE 905
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3277
Mailing Address - Country:US
Mailing Address - Phone:321-342-4948
Mailing Address - Fax:321-342-7451
Practice Address - Street 1:1980 N ATLANTIC AVE STE 905
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-3277
Practice Address - Country:US
Practice Address - Phone:321-342-4948
Practice Address - Fax:321-342-7451
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11017204207Q00000X
FLAPRN11017204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine