Healthcare Provider Details

I. General information

NPI: 1215479803
Provider Name (Legal Business Name): SHYNE PILLAI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 N UNIVERSITY DR
HOLLYWOOD FL
33024-2222
US

IV. Provider business mailing address

3105 N UNIVERSITY DR
HOLLYWOOD FL
33024-2222
US

V. Phone/Fax

Practice location:
  • Phone: 954-438-6080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 9407214
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP 9407214
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: