Provider Demographics
NPI:1205369048
Name:ABDUL, HALEEM SHAHNAWAZ (MD)
Entity type:Individual
Prefix:
First Name:HALEEM
Middle Name:SHAHNAWAZ
Last Name:ABDUL
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 1:3110 N PINE ISLAND RD APT 103
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7302
Mailing Address - Country:US
Mailing Address - Phone:305-978-8580
Mailing Address - Fax:800-792-9021
Practice Address - Street 1:1400 NW 10TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1000
Practice Address - Country:US
Practice Address - Phone:305-243-9890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME150602207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine