Doctor Name: | DR. JOEL SHLIAN |
NPI Number: | 1003168691 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME75214 |
Business Practice Address: | 3148 Nw 63rd St Boca Raton, FL - 334963311 |
Business Phone Number: | 5619888780 |
Business Fax Number: | 5619888794 |
Mailing Address: | 3148 Nw 63rd St, BOCA RATON |
State: | FL |
Postal Code: | 334963311 |
Phone Number: | 5619888780 |
Fax Number: | |
NPI Enumeration Date: | 10/08/2012 |
NPI Last Update Date: | 10/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | ME75214 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |