Healthcare Provider Details

I. General information

NPI: 1093257800
Provider Name (Legal Business Name): AMIR SHAPIRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

3215 NE 184TH ST APT. 14302
AVENTURA FL
33160-4994
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-6891
  • Fax:
Mailing address:
  • Phone: 305-713-4962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberTRN# 23961
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: