Provider Demographics
NPI:1700824521
Name:SHAPIRO, CRAIG J (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:J
Last Name:SHAPIRO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2 SHIRCLIFF WAY
Mailing Address - Street 2:SUITE 700 DEPAUL BLDG.
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4763
Mailing Address - Country:US
Mailing Address - Phone:904-389-5333
Mailing Address - Fax:904-389-5332
Practice Address - Street 1:836 PRUDENTIAL DRIVE
Practice Address - Street 2:SUITE 1502 PAVILION BLDG
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:904-398-1111
Practice Address - Fax:904-389-5332
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2024-10-24
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Provider Licenses
StateLicense IDTaxonomies
FLME94599207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004853300Medicaid
FL161954Medicare UPIN
FLU8095ZMedicare PIN