Provider Demographics
NPI:1164672424
Name:TARAZI, SHADI SAMI (MD,)
Entity Type:Individual
Prefix:DR
First Name:SHADI
Middle Name:SAMI
Last Name:TARAZI
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 NE 32ND ST UNIT 607
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5248
Mailing Address - Country:US
Mailing Address - Phone:312-752-7412
Mailing Address - Fax:
Practice Address - Street 1:650 NE 32ND ST UNIT 607
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5248
Practice Address - Country:US
Practice Address - Phone:312-752-7412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-053272207R00000X
MA242726207R00000X
FLME149783207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine