Provider Demographics
NPI:1336124296
Name:SHAFRAN, IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:
Last Name:SHAFRAN
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 1:701 W MORSE BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3731
Mailing Address - Country:US
Mailing Address - Phone:407-629-8121
Mailing Address - Fax:407-629-7250
Practice Address - Street 1:701 W MORSE BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3731
Practice Address - Country:US
Practice Address - Phone:407-629-8121
Practice Address - Fax:407-629-7250
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0033950207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0033950OtherSTATE LICENSE
FLD55544Medicare UPIN
FL48998WMedicare PIN