Provider Demographics
NPI:1710168943
Name:ROSARIO, SHAH MICHAEL ASADI (PT)
Entity Type:Individual
Prefix:
First Name:SHAH MICHAEL
Middle Name:ASADI
Last Name:ROSARIO
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Gender:M
Credentials:PT
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Other - Credentials:
Mailing Address - Street 1:3290 NORTH RIDGE ROAD EXECUTIVE CENTER II
Mailing Address - Street 2:SUITE 290
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3655
Mailing Address - Country:US
Mailing Address - Phone:410-750-9006
Mailing Address - Fax:410-750-0787
Practice Address - Street 1:3201 W. COMMERCIAL BLVD,
Practice Address - Street 2:SUITE 116
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3440
Practice Address - Country:US
Practice Address - Phone:800-886-8108
Practice Address - Fax:954-332-4340
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
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Provider Licenses
StateLicense IDTaxonomies
FL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist