MEDICARE: DR. SHADI S TARAZI M.D.,

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	207R00000X	Internal Medicine Physician	242726	MA
2	207R00000X	Internal Medicine Physician	125-053272	IL
3	207RN0300X	Nephrology Physician	ME149783	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	:	1164672424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHADI S TARAZI M.D.,

Provider Business Mailing Address
First Line	:	1680 MICHIGAN AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2538
Country	:	US
Telephone Number	:	305-842-6560
Fax Number	:

Provider Business Practice Location Address
First Line	:	1680 MICHIGAN AVE STE 916
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2550
Country	:	US
Telephone Number	:	305-842-6560
Fax Number	:

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

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	04/16/2026

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