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General NPI Number Information
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NPI Number | 1922152842
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Entity Type | Individual
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Provider Name | HADI A SHALHOUB DO
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 13110 US HIGHWAY 1
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City | SEBASTIAN
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State | FL
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Zip | 32958-3735
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Country | US
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Telephone | 772-581-8900
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Fax | 772-581-4499
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Provider Business Mailing Address
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Address Line | 13100 US HIGHWAY 1
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City | SEBASTIAN
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State | FL
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Zip | 32958-3735
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Country | US
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Telephone | 772-581-8900
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Fax | 772-581-4478
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS7619
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | OS 7619
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License Number State | FL
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