| Dr Parvonae Shaw P A | |
|
840 Azalea Ct Plantation FL 33317-1202 | |
| (954) 205-4369 | |
| Not Available |
| Full Name | Dr Parvonae Shaw P A |
|---|---|
| Speciality | Psychologist |
| Location | 840 Azalea Ct, Plantation, Florida |
| Authorized Official Name and Position | Parvonae Shaw (PRESIDENT/PSYCHOLOGIST) |
| Authorized Official Contact | 9542054369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Parvonae Shaw P A 840 Azalea Ct Plantation FL 33317-1202 Ph: () - | Dr Parvonae Shaw P A 840 Azalea Ct Plantation FL 33317-1202 Ph: (954) 205-4369 |
| NPI Number | 1083860019 |
|---|---|
| Provider Enumeration Date | 08/11/2008 |
| Last Update Date | 01/20/2010 |
| Medicare PECOS PAC ID | 3870641954 |
|---|---|
| Medicare Enrollment ID | O20090429000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083860019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 7580 (Florida) | Primary |
| Provider Name | Parvonae M Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760679690 PECOS PAC ID: 4082797451 Enrollment ID: I20080320000527 |
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