Healthcare Provider Details

I. General information

NPI: 1205369048
Provider Name (Legal Business Name): HALEEM SHAHNAWAZ ABDUL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2017
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NW 10TH AVE
MIAMI FL
33136-1000
US

IV. Provider business mailing address

3110 N PINE ISLAND RD APT 103
SUNRISE FL
33351-7302
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-9890
  • Fax:
Mailing address:
  • Phone: 305-978-8580
  • Fax: 800-792-9021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number334043
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number199823
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME150602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: