Provider Demographics
NPI:1255400685
Name:SHAO, LAIBAO (AP)
Entity type:Individual
Prefix:DR
First Name:LAIBAO
Middle Name:
Last Name:SHAO
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 BELVEDERE RD STE 109-110
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3607
Mailing Address - Country:US
Mailing Address - Phone:561-791-9970
Mailing Address - Fax:561-791-9971
Practice Address - Street 1:9100 BELVEDERE RD STE 109-110
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3607
Practice Address - Country:US
Practice Address - Phone:561-791-9970
Practice Address - Fax:561-791-9971
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1189171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist