Provider Demographics
NPI:1275551442
Name:SHAPIRO, ELTON TIMOTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELTON
Middle Name:TIMOTHY
Last Name:SHAPIRO
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 1:2801 NE 213TH ST STE 1015
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1266
Mailing Address - Country:US
Mailing Address - Phone:305-937-3000
Mailing Address - Fax:305-936-8227
Practice Address - Street 1:2801 NE 213TH ST STE 1015
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1266
Practice Address - Country:US
Practice Address - Phone:305-937-3000
Practice Address - Fax:888-268-0675
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58021207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10948Medicare ID - Type Unspecified
E66574Medicare UPIN