Healthcare Provider Details

I. General information

NPI: 1598740664
Provider Name (Legal Business Name): DAVID LEWIS SHAPIRO PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 SHERIDAN ST SUITE A
HOLLYWOOD FL
33021-3624
US

IV. Provider business mailing address

3860 SHERIDAN ST SUITE A
HOLLYWOOD FL
33021-3624
US

V. Phone/Fax

Practice location:
  • Phone: 954-322-0348
  • Fax: 954-322-0397
Mailing address:
  • Phone: 954-322-0348
  • Fax: 954-322-0397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPY6208
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: