Provider Demographics
NPI:1154379923
Name:SHLAMOWITZ, MORRIS (MD)
Entity type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:
Last Name:SHLAMOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 10TH AVE N
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3369
Mailing Address - Country:US
Mailing Address - Phone:561-540-4458
Mailing Address - Fax:561-540-5939
Practice Address - Street 1:1926 10TH AVE N
Practice Address - Street 2:SUITE 105
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-3369
Practice Address - Country:US
Practice Address - Phone:561-540-4458
Practice Address - Fax:561-540-5939
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44967174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE65223Medicare UPIN
FL09124XMedicare ID - Type Unspecified