Provider Demographics
NPI:1407359748
Name:SHIBI, OREN BURMAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:OREN
Middle Name:BURMAN
Last Name:SHIBI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S UNIVERSITY DR STE A
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3330
Mailing Address - Country:US
Mailing Address - Phone:954-577-0901
Mailing Address - Fax:954-423-0901
Practice Address - Street 1:120 S UNIVERSITY DR STE A
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3330
Practice Address - Country:US
Practice Address - Phone:954-577-0901
Practice Address - Fax:954-423-0901
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9424103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical