Provider Demographics
NPI:1831145093
Name:DADI, SHAUL S (MD)
Entity Type:Individual
Prefix:
First Name:SHAUL
Middle Name:S
Last Name:DADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 ROYAL ORCHID CIR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-4338
Mailing Address - Country:US
Mailing Address - Phone:561-498-8595
Mailing Address - Fax:
Practice Address - Street 1:10301 HAGEN RANCH RD
Practice Address - Street 2:SUITE B 550
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3724
Practice Address - Country:US
Practice Address - Phone:888-407-6166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70810207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250459600Medicaid
FL31283Medicare PIN
FLF86624Medicare UPIN