Healthcare Provider Details

I. General information

NPI: 1023695996
Provider Name (Legal Business Name): SHIWEI HAN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 01/17/2026
Certification Date: 01/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N FEDERAL HWY STE 411
HALLANDALE BEACH FL
33009-2464
US

IV. Provider business mailing address

601 N FEDERAL HWY STE 411
HALLANDALE BEACH FL
33009-2464
US

V. Phone/Fax

Practice location:
  • Phone: 754-288-3171
  • Fax:
Mailing address:
  • Phone: 754-288-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME168579
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: