Provider Demographics
NPI:1184720849
Name:WILLIAM A SHAPSE MD LLC
Entity type:Organization
Organization Name:WILLIAM A SHAPSE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAPSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-496-0176
Mailing Address - Street 1:5341 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8167
Mailing Address - Country:US
Mailing Address - Phone:561-496-0176
Mailing Address - Fax:561-496-0482
Practice Address - Street 1:906A SOUTH FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-5671
Practice Address - Country:US
Practice Address - Phone:561-736-0015
Practice Address - Fax:561-736-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061783207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0061783OtherFL LIC
AS1023427OtherDEA
FLC56531Medicare UPIN
FL18329Medicare PIN