NPI 1558010389 · live from the CMS NPI Registry
Shan Ali, MD
Pain Medicine, Interventional Pain Medicine in Jacksonville, FL. National Provider Identifier 1558010389, active.
NPI record
| NPI | 1558010389 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pain Medicine, Interventional Pain Medicine 208VP0014X |
| Practice location | 4500 San Pablo Rd S, Jacksonville, FL 32224 |
| Practice phone | 904-953-2000 |
| Enumerated | March 21, 2022 |
| Last updated | September 13, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology | 2084N0400X | ME169939 (FL) |
| Pain Medicine, Interventional Pain Medicine primary | 208VP0014X | ME169939 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.