Provider Demographics
NPI:1134120843
Name:SHAPIRO, CRAIG STEVEN (DO)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:STEVEN
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3039 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5536
Mailing Address - Country:US
Mailing Address - Phone:954-900-1497
Mailing Address - Fax:954-678-2592
Practice Address - Street 1:3039 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5536
Practice Address - Country:US
Practice Address - Phone:955-900-1497
Practice Address - Fax:954-678-2592
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6777207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376294700Medicaid
FL376294700Medicaid