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Individual

MR. JESSE SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
17779 SW 2ND ST, PEMBROKE PINES, FL 33029-3924
(954) 450-0099
(954) 450-0022
Mailing address
17779 SW 2ND ST, PEMBROKE PINES, FL 33029-3924
(954) 450-0099
(954) 450-0022

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
OS10003
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
278697400
FL
Enumeration date
03/30/2007
Last updated
08/27/2025
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