Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME75214 | FL |
NPI | 1003168691 |
---|---|
Provider Name | Dr. Joel Shlian |
First Address | Boca Raton, FL 33496-3311 |
Second Address | Boca Raton, FL 33496-3311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2012 |
Last Update Date | 08/10/2012 |