Healthcare Provider Details

I. General information

NPI: 1184800211
Provider Name (Legal Business Name): SHABANA AKHTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2939 N MILITARY TRL
WEST PALM BEACH FL
33409-2916
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 561-863-5757
  • Fax: 561-863-6627
Mailing address:
  • Phone: 561-863-5757
  • Fax: 561-863-6627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTL32095
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number002146
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME113770
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: