MEDICARE: SHINO BAY COSMETIC DERMATOLOGY & LASER INSTITUTE LLC

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	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1164690582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHINO BAY COSMETIC DERMATOLOGY & LASER INSTITUTE LLC

Provider Business Mailing Address
First Line	:	350 E LAS OLAS BLVD
Second Line	:	SUITE 110
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-4211
Country	:	US
Telephone Number	:	954-765-3005
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 E LAS OLAS BLVD
Second Line	:	SUITE 110
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-4211
Country	:	US
Telephone Number	:	954-765-3005
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHINO B AGUILERA
Credential	:	DO
Telephone Number	:	954-765-3005

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	09/08/2008

Similar Medicare Providers

1649585639 — DR. LUIS ALBERTO SORO JR. D.O.
Practice Location Address:

350 E LAS OLAS BLVD , SUITE 110
FORT LAUDERDALE, FL
33301-4211

Practice Phone: 954-765-3005
Practice Fax:

1043299456 — STEVEN GARY KESSLER MD
Practice Location Address:

1212 E BROWARD BLVD STE 204
FT LAUDERDALE, FL
33301-2121

Practice Phone: 954-496-4591
Practice Fax:

1538130281 — R. G. STRATT MD, PA
Practice Location Address:

100 N FEDERAL HWY , SUITE C-2
FT LAUDERDALE, FL
33301-1129

Practice Phone: 954-765-1316
Practice Fax: 954-765-1461

1861456543 — DR. ROBERT K HALL D.P.M.
Practice Location Address:

1211 E BROWARD BLVD
FT LAUDERDALE, FL
33301-2129

Practice Phone: 954-467-8554
Practice Fax: 954-467-0119

1801850797 — JOSE ORLANDO RUIZ P.T.
Practice Location Address:

1212 E BROWARD BLVD , SUITE 300
FT LAUDERDALE, FL
33301-2123

Practice Phone: 954-462-1526
Practice Fax: 954-761-9625

1336190537 — LAUDERDALE ORTHOPAEDIC SURGEONS LLP
Practice Location Address:

1212 E BROWARD BLVD , SUITE 300
FT LAUDERDALE, FL
33301-2123

Practice Phone: 954-739-4420
Practice Fax: 954-733-4092

Directions to “SHINO BAY COSMETIC DERMATOLOGY & LASER INSTITUTE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.