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Individual

LESLIE G SHAWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
400 NORTH HIATUS ROAD, SUITE 201, PEMBROKE PINES, FL 33026
(954) 442-3434
(954) 441-4425
Mailing address
400 NORTH HIATUS ROAD, SUITE 201, PEMBROKE PINES, FL 33026
(954) 442-3434
(954) 441-4425

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0003957
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0378046-00
FL
Enumeration date
05/08/2006
Last updated
11/23/2009
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