Healthcare Provider Details

I. General information

NPI: 1730096785
Provider Name (Legal Business Name): MARIA SHUBA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 COLLEGE AVE
DAVIE FL
33314-7721
US

IV. Provider business mailing address

400 KINGS POINT DR APT 824
SUNNY ISLES BEACH FL
33160-4701
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-8000
  • Fax:
Mailing address:
  • Phone: 407-777-4477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: