Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | DOS-708 | HI |
Y | 2080P0208X | Pediatric Infectious Diseases | OS14933 | FL |
NPI | 1588634398 |
---|---|
Provider Name | Dr. David Shapiro |
First Address | Pensacola, FL 32513-2699 |
Second Address | Pensacola, FL 32504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 07/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OTH000 | (02) |