Provider Demographics
NPI:1427174697
Name:SHABANAH, FIKRI H (M D)
Entity type:Individual
Prefix:
First Name:FIKRI
Middle Name:H
Last Name:SHABANAH
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:VICTOR
Other - Middle Name:H
Other - Last Name:SHABANAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:M D
Mailing Address - Street 1:495 BILTMORE WAY
Mailing Address - Street 2:306
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5756
Mailing Address - Country:US
Mailing Address - Phone:305-442-0015
Mailing Address - Fax:305-442-0082
Practice Address - Street 1:495 BILTMORE WAY
Practice Address - Street 2:306
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5756
Practice Address - Country:US
Practice Address - Phone:305-442-0015
Practice Address - Fax:305-442-0082
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0019385207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease