Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | OS17994 | FL |
NPI | 1114346285 |
---|---|
Provider Name | Asif Shafiq |
First Address | Pompano Beach, FL 33062-7500 |
Second Address | Pompano Beach, FL 33062-7500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 15/12/2021 |