Provider Demographics
NPI:1285816496
Name:ALAM, SHELLA (PA)
Entity type:Individual
Prefix:
First Name:SHELLA
Middle Name:
Last Name:ALAM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8525 SW 92 ST
Mailing Address - Street 2:SUITE C10
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156
Mailing Address - Country:US
Mailing Address - Phone:305-274-7800
Mailing Address - Fax:305-270-1246
Practice Address - Street 1:8525 SW 92ND ST
Practice Address - Street 2:SUITE C10
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7365
Practice Address - Country:US
Practice Address - Phone:305-274-7800
Practice Address - Fax:305-270-1246
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9101495363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical