Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shahab Nouri, PA-C

Individual provider Physician Assistant · NPI 1992517916

Shahab Nouri, PA-C is a Physician Assistant in Lecanto, Florida. Qualified in 2025, 1 year ago. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

525 N Dacie Pt
Lecanto, FL 34461-8399
Phone: (813) 321-1786
Fax: (813) 321-1787
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9121103 (FL)

Record details

NPI number1992517916
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 25, 2025
Last updated in NPPESMay 2, 2026
Certification dateMay 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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