Individual
MR. ABDUL R SHADANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2215 NEBRASKA AVE, STE 1B2, FORT PIERCE, FL 34950-4897
(772) 466-7171
(772) 466-7266
Mailing address
2215 NEBRASKA AVE, SUITE 1B2, FT PLIERCE, FL 34950-4897
(772) 466-7171
(772) 466-7266
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME40659
FL
207RC0000X
Cardiovascular Disease Physician
Primary
ME0040659
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0683500700
—
FL
Enumeration date
02/09/2007
Last updated
06/13/2013
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