Provider Demographics
NPI:1912001256
Name:SHUMAN, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SHUMAN
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 1:7150 WEST 20TH AVENUE
Mailing Address - Street 2:SUITE 408
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016
Mailing Address - Country:US
Mailing Address - Phone:305-821-6368
Mailing Address - Fax:305-822-6697
Practice Address - Street 1:7150 WEST 20TH AVENUE
Practice Address - Street 2:SUITE 408
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-821-6368
Practice Address - Fax:305-822-6697
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0018510207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056938100Medicaid
91853Medicare ID - Type Unspecified
FL056938100Medicaid