Provider Demographics
NPI:1104141738
Name:'ASHRAFI, SHADI (MD)
Entity type:Individual
Prefix:DR
First Name:SHADI
Middle Name:
Last Name:'ASHRAFI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 KUHL AVE
Mailing Address - Street 2:PATHOLOGY 2B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2008
Mailing Address - Country:US
Mailing Address - Phone:321-841-8933
Mailing Address - Fax:321-843-6219
Practice Address - Street 1:1414 KUHL AVE
Practice Address - Street 2:PATHOLOGY 2B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2008
Practice Address - Country:US
Practice Address - Phone:321-841-8933
Practice Address - Fax:321-843-6219
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN14121390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program