Provider Demographics
NPI:1699945980
Name:SHENAI, SHAILA MARIE (MD)
Entity type:Individual
Prefix:
First Name:SHAILA
Middle Name:MARIE
Last Name:SHENAI
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 1:2804 W MARC KNIGHTON CT UNIT 10
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-6308
Mailing Address - Country:US
Mailing Address - Phone:352-527-7380
Mailing Address - Fax:352-240-3921
Practice Address - Street 1:2000 NE 30TH AVE BLDG L
Practice Address - Street 2:CITY OF OCALA HEALTH AND WELLNESS CENTER
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34478
Practice Address - Country:US
Practice Address - Phone:877-423-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD439424207R00000X
NE24497207RG0300X
FLME110510207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0234711Medicaid
PA102532934Medicaid
PA186653Medicare PIN