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General NPI Number Information
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NPI Number | 1720442130
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Entity Type | Individual
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Provider Name | JUSTIN SHEMESH D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 140A S FEDERAL HWY
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City | DANIA BEACH
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State | FL
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Zip | 33004-3623
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Country | US
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Telephone | 954-276-5552
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Fax | 954-922-6898
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Provider Business Mailing Address
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Address Line | 2900 CORPORATE WAY DOOR D
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City | MIRAMAR
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State | FL
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Zip | 33025-3925
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Country | US
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Telephone | 954-276-5603
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Fax | 954-985-7074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS14975
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License Number State | FL
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