Provider Demographics
NPI:1215132980
Name:SHINTRE, NIRANJAN J (MD)
Entity type:Individual
Prefix:
First Name:NIRANJAN
Middle Name:J
Last Name:SHINTRE
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 1:3001 CORAL HILLS DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4172
Mailing Address - Country:US
Mailing Address - Phone:954-755-0111
Mailing Address - Fax:954-755-2209
Practice Address - Street 1:3001 CORAL HILLS DR
Practice Address - Street 2:SUITE 320
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4172
Practice Address - Country:US
Practice Address - Phone:954-755-0111
Practice Address - Fax:954-755-2209
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102451208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME102451OtherMEDICAL LICENSE
FL000534200Medicaid
FLAR933ZMedicare PIN