Organization Active NPI

Shakeela Tawwab MD PA

  • Gynecology Physician
  • Deltona, FL
National Provider Identifier
1932474368
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
SHAKEELA TAWWAB MD PA
Practice address
780 Deltona Blvd Ste 104
Deltona, FL 32725-7128
Phone
(386) 574-5565
Fax
(386) 574-8567
NPI assigned
Mar 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Shakeela TawwabNPI 1679579783
Title
MD
Phone
(386) 574-5565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

780 Deltona Blvd Ste 104
Deltona, FL 32725-7128

Mailing address

780 Deltona Blvd
#104
Deltona, FL 32725-7128
Phone (386) 574-5565

Other identifiers 1

IdentifierTypeStateIssuer
036053800MedicaidFL

Other names 1

  • SHAKEELA TAWWAB MD PA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120606000188 FL Part B Supplier - Clinic/Group Practice 6608030556 Receives reassigned benefits from 2 practitioners
Practice locations: Deltona, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1932474368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 DELTONA BLVD",
            "address_2": "#104",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327257128",
            "telephone_number": "386-574-5565",
            "fax_number": "386-574-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 DELTONA BLVD STE 104",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327257128",
            "telephone_number": "386-574-5565",
            "fax_number": "386-574-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAKEELA TAWWAB MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "TAWWAB",
        "authorized_official_first_name": "SHAKEELA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "386-574-5565",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHAKEELA TAWWAB MD PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deltona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.