Individual
DR. SHABBIR H EZUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, BOX 016960 (M851), MIAMI, FL 33136-1005
(305) 243-6358
(305) 243-8470
Mailing address
1611 NW 12TH AVE, BOX 016960 (M851), MIAMI, FL 33136-1005
(305) 243-6358
(305) 243-8470
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
ME60816
FL
2085R0202X
Diagnostic Radiology Physician
ME60816
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0576271-00
—
FL
Enumeration date
07/09/2006
Last updated
05/13/2025
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