Doctor Name: | FADI ABU SHAHIN |
NPI Number: | 1265608806 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 8931 Colonial Center Dr Suite 400 Fort Myers, FL - 339057809 |
Business Phone Number: | 2393346626 |
Business Fax Number: | 2393340404 |
Mailing Address: | 2234 Colonial Blvd, Attn: Managed Care Dept FORT MYERS |
State: | FL |
Postal Code: | 339071412 |
Phone Number: | 2399317342 |
Fax Number: | 2399317385 |
NPI Enumeration Date: | 05/04/2008 |
NPI Last Update Date: | 05/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |