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General NPI Number Information
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NPI Number | 1992053938
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Entity Type | Individual
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Provider Name | SHALINI MEERA BOODRAM MD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2012
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | REHAB ADMINISTRATION INTERFAITH-2 901 45TH STREET
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City | WEST PALM BEACH
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State | FL
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Zip | 33407
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Country | US
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Telephone | 561-884-6494
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Fax | 561-841-9953
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Provider Business Mailing Address
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Address Line | 11259 66TH ST N
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City | WEST PALM BEACH
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State | FL
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Zip | 33412-1838
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Country | US
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Telephone | 248-497-9456
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Fax | 772-223-8938
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD15469
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License Number State | RI
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