Shaw, Jesse
Shaw, Jesse is an sole proprietor health care provider with primary practice located at 17779 Sw 2Nd St , Pembroke Pines FL 33029-3924. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Shaw, Jesse can be contacted via phone (954) 450-0099.Contact Information
Primary practice address
17779 Sw 2Nd St
Pembroke Pines FL 33029-3924
Phone: (954) 450-0099
Fax: (954) 450-0022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | OS10003 | Florida |
Profile Details
| NPI number | 1396865788 |
|---|---|
| LBN Legal business name | Shaw, Jesse |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 30th, 2007 |
| Last updated | Nov 15th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396865788 | NPPES |
| Florida | MEDICAID | 278697400 |
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