Individual ProviderSandrela Mussallam Abu ShaibehHospitalistAllopathic & Osteopathic PhysiciansPractice Address820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205(904) 202-3860(904) 202-2092PECOS EnrollmentBased on the most recent information from CMS, provider Sandrela Mussallam Abu Shaibeh is legally eligible to order and refer claims for Part B, HHA and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:21 AM.Profile DetailsProvider ID1003161480Provider TypeIndividualFull NameMussallam Abu Shaibeh, SandrelaGenderFemaleSole ProprietorNoEnumeration Date7/20/2012Last Updated8/13/2024Contact InformationPractice LocationPractice Address820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205Phone(904) 202-3860Fax(904) 202-3846Mailing LocationMailing AddressPO Box 746638, Atlanta, GA 30374-6638Phone(904) 202-2092Fax(904) 376-4075Provider TaxonomiesCodeDescriptionLicenseCode208M00000XPrimaryDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseME132486FloridaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense26495West VirginiaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseME132486Florida