MEDICARE: DR. MARC D SHAPIRO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME28268	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134184070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC D SHAPIRO MD

Provider Business Mailing Address
First Line	:	2111 GLENWOOD DR STE 101
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-3328
Country	:	US
Telephone Number	:	407-478-1550
Fax Number	:	407-478-1540

Provider Business Practice Location Address
First Line	:	2111 GLENWOOD DR STE 101
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-3328
Country	:	US
Telephone Number	:	407-478-1550
Fax Number	:	407-478-1540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	05/24/2012

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