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General NPI Number Information
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NPI Number | 1760586044
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Entity Type | Individual
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Provider Name | MICHAEL ROY SHOOK MD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 375 NW 51 ST
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City | BOCA RATON
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State | FL
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Zip | 33431
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Country | US
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Telephone | 561-997-8111
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Fax | 561-995-0109
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Provider Business Mailing Address
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Address Line | 8016 MIZNER LN
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City | BOCA RATON
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State | FL
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Zip | 33433-1134
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Country | US
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Telephone | 800-427-1902
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Fax | 561-883-6071
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME50883
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License Number State | FL
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