Provider Demographics
NPI:1639276694
Name:SHAPIRO AND BORENSTEIN DERMATOLOGY LLP
Entity Type:Organization
Organization Name:SHAPIRO AND BORENSTEIN DERMATOLOGY LLP
Other - Org Name:GARDENS DERMATOLOGY & COSMETIC SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-776-7041
Mailing Address - Street 1:11030 RCA CENTER DR
Mailing Address - Street 2:SUITE 3015
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4276
Mailing Address - Country:US
Mailing Address - Phone:561-776-7041
Mailing Address - Fax:561-776-7043
Practice Address - Street 1:11030 RCA CENTER DR
Practice Address - Street 2:SUITE 3015
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4276
Practice Address - Country:US
Practice Address - Phone:561-776-7041
Practice Address - Fax:561-776-7043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56948207N00000X
FLME89837207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I09572Medicare UPIN
FLV2753ZMedicare PIN
FL38793Medicare PIN
F82765Medicare UPIN