Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 13553 | NV |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 63057 | GA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME116072 | FL |
NPI | 1093992653 |
---|---|
Provider Name | Michael Timothy Shapiro |
First Address | Tavares, FL 32778-9648 |
Second Address | Las Vegas, NV 89117-2873 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2008 |
Last Update Date | 07/12/2020 |