Provider Demographics
NPI:1972713774
Name:KATYAL, SHALINI (MD)
Entity Type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:KATYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 LAKE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-2509
Mailing Address - Country:US
Mailing Address - Phone:954-812-2140
Mailing Address - Fax:
Practice Address - Street 1:3111 LAKE RIDGE LN
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33332-2509
Practice Address - Country:US
Practice Address - Phone:954-812-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 977592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry