Provider Demographics
NPI:1316917891
Name:SHULMAN, JOEL S (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:S
Last Name:SHULMAN
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 1:333 NW 70TH AVE
Mailing Address - Street 2:#116
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317
Mailing Address - Country:US
Mailing Address - Phone:954-581-6041
Mailing Address - Fax:954-581-0222
Practice Address - Street 1:333 NW 70TH AVE
Practice Address - Street 2:#116
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317
Practice Address - Country:US
Practice Address - Phone:954-581-6041
Practice Address - Fax:954-581-0222
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME25889207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371830100Medicaid
D79539Medicare UPIN
92760Medicare ID - Type Unspecified