Provider Demographics
NPI:1164823878
Name:MAY, SHIRA D
Entity Type:Individual
Prefix:
First Name:SHIRA
Middle Name:D
Last Name:MAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHIRA
Other - Middle Name:D
Other - Last Name:SAKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6640 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1912
Mailing Address - Country:US
Mailing Address - Phone:347-444-8697
Mailing Address - Fax:
Practice Address - Street 1:7284 W PALMETTO PARK RD STE 105S
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3406
Practice Address - Country:US
Practice Address - Phone:305-336-5381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-290377106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician