Provider Demographics
NPI:1578612529
Name:SHAW, MUREEN LEONIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MUREEN
Middle Name:LEONIE
Last Name:SHAW
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:MUREEN
Other - Middle Name:LEONIE
Other - Last Name:ARTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:11300 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33161-6628
Mailing Address - Country:US
Mailing Address - Phone:305-899-3824
Mailing Address - Fax:
Practice Address - Street 1:5409 SW 125TH TER
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-5480
Practice Address - Country:US
Practice Address - Phone:305-829-4912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2757902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304971000Medicaid