Provider Demographics
NPI:1528107125
Name:DON S. SHALHUB
Entity type:Organization
Organization Name:DON S. SHALHUB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:S
Authorized Official - Last Name:SALHUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-557-3311
Mailing Address - Street 1:7100 W. 20TH AVENUE
Mailing Address - Street 2:S. 414
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016
Mailing Address - Country:US
Mailing Address - Phone:305-557-3311
Mailing Address - Fax:305-444-3530
Practice Address - Street 1:7100 W. 20TH AVENUE
Practice Address - Street 2:S. 414
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-557-3311
Practice Address - Fax:305-444-3530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78474AMedicare ID - Type Unspecified