Provider Demographics
NPI:1699248286
Name:MOMIN, SHAINA (NP)
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:
Last Name:MOMIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:561-570-5172
Mailing Address - Fax:786-472-5770
Practice Address - Street 1:5920 FM 78
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78219
Practice Address - Country:US
Practice Address - Phone:210-662-0076
Practice Address - Fax:210-396-7021
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily