Provider Demographics
NPI:1326533282
Name:SHANBLATT, ASHLEY ANN (DO)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ANN
Last Name:SHANBLATT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7857 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2600
Mailing Address - Country:US
Mailing Address - Phone:954-518-7000
Mailing Address - Fax:954-518-7049
Practice Address - Street 1:7857 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-2600
Practice Address - Country:US
Practice Address - Phone:954-518-7000
Practice Address - Fax:954-518-7049
Is Sole Proprietor?:No
Enumeration Date:2018-06-24
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS16315207Q00000X
FLUO5899390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111048100Medicaid