Provider Demographics
NPI:1437257292
Name:SHIFRIN, GARY S (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:S
Last Name:SHIFRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:600 UNIVERSITY BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2778
Mailing Address - Country:US
Mailing Address - Phone:561-478-1104
Mailing Address - Fax:561-478-9505
Practice Address - Street 1:1401 FORUM WAY
Practice Address - Street 2:#300
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-478-1104
Practice Address - Fax:561-478-9505
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME53556207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378711700Medicaid
A62153Medicare UPIN