Provider Demographics
NPI:1457346165
Name:SHAPIRO, JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
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 1:777 ARTHUR GODFREY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3444
Mailing Address - Country:US
Mailing Address - Phone:305-763-8832
Mailing Address - Fax:305-763-8883
Practice Address - Street 1:777 ARTHUR GODFREY RD STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3444
Practice Address - Country:US
Practice Address - Phone:305-763-8832
Practice Address - Fax:305-763-8883
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07863400207R00000X, 208D00000X
FLME93229207R00000X
FLME93220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1457346165OtherINTERNAL MEDICINE
NJ093269Medicare ID - Type Unspecified
NJ0079294Medicaid