Provider Demographics
NPI:1073640199
Name:SHITTA-BEY, ABIOLA AINA (MD,)
Entity Type:Individual
Prefix:
First Name:ABIOLA
Middle Name:AINA
Last Name:SHITTA-BEY
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5607 NW 27TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-2826
Mailing Address - Country:US
Mailing Address - Phone:305-805-1700
Mailing Address - Fax:305-805-1772
Practice Address - Street 1:PO BOX 22428
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33335-2428
Practice Address - Country:US
Practice Address - Phone:305-805-1700
Practice Address - Fax:305-805-1772
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118786207V00000X
IL036-125824207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC1-0009933OtherDE LICENSE