Healthcare Provider Details

I. General information

NPI: 1356470744
Provider Name (Legal Business Name): ENGLEWOOD PEDIATRICS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2007
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3670 N ACCESS RD
ENGLEWOOD FL
34224-8888
US

IV. Provider business mailing address

3670 N ACCESS RD
ENGLEWOOD FL
34224-8888
US

V. Phone/Fax

Practice location:
  • Phone: 941-474-5093
  • Fax: 941-474-9049
Mailing address:
  • Phone: 941-474-5093
  • Fax: 941-474-9049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0059964
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number0059964
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number800002855
License Number StateFL

VIII. Authorized Official

Name: DR. SHAHAB EUNUS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 941-474-5093