Healthcare Provider Details

I. General information

NPI: 1508976481
Provider Name (Legal Business Name): DR. JENNIFER SHAMUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17796 SW 2ND ST
PEMBROKE PINES FL
33029-3923
US

IV. Provider business mailing address

17571 SW 7TH ST
PEMBROKE PINES FL
33029-4207
US

V. Phone/Fax

Practice location:
  • Phone: 954-438-7800
  • Fax:
Mailing address:
  • Phone: 305-435-1125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT10352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: