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General NPI Number Information
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NPI Number | 1982095352
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Entity Type | Individual
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Provider Name | WILLIAM JASON SHURE M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2015
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Last Update Date | 02/06/2015
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Provider Practice Location Address
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Address Line | 1047 S SOUTHLAKE DR
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City | HOLLYWOOD
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State | FL
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Zip | 33019-1948
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Country | US
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Telephone | 954-980-1060
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Fax | 954-927-2292
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Provider Business Mailing Address
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Address Line | 1047 S SOUTHLAKE DR
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City | HOLLYWOOD
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State | FL
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Zip | 33019-1948
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Country | US
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Telephone | 954-980-1060
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Fax | 954-927-2292
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME 0037427
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 140158-1
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License Number State | NY
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