Provider Demographics
NPI:1730119322
Name:SHAPIRO, MARC D (DO)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:D
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-1565
Mailing Address - Fax:954-927-0945
Practice Address - Street 1:1740 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-2275
Practice Address - Country:US
Practice Address - Phone:954-276-1565
Practice Address - Fax:954-927-0945
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2021-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010526500Medicaid
FL80183OtherBLUE SHIELD OF FL
E56658Medicare UPIN
FL058160700Medicaid