Healthcare Provider Details

I. General information

NPI: 1356696744
Provider Name (Legal Business Name): SHAKIR M ALATTAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2012
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1571 SAWGRASS CORPORATE PKWY STE 140
SUNRISE FL
33323-2807
US

IV. Provider business mailing address

9450 PINECROFT DR PO BOX 7121
SPRING TX
77380-9998
US

V. Phone/Fax

Practice location:
  • Phone: 800-400-6354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberQ1937
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME133486
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: