Healthcare Provider Details

I. General information

NPI: 1598567380
Provider Name (Legal Business Name): STELA SHABANI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 BELVEDERE RD
ROYAL PALM BEACH FL
33411-3640
US

IV. Provider business mailing address

5900 SW 58TH CT
DAVIE FL
33314-7310
US

V. Phone/Fax

Practice location:
  • Phone: 561-273-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9120273
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9120273
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9120273
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: