Provider Demographics
NPI:1245358084
Name:SHAPIRO, BARRY DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:DAVID
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13301 ORANGE GROVE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2915
Mailing Address - Country:US
Mailing Address - Phone:813-962-3608
Mailing Address - Fax:813-961-8384
Practice Address - Street 1:13301 ORANGE GROVE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2915
Practice Address - Country:US
Practice Address - Phone:813-962-3608
Practice Address - Fax:813-961-8384
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88406Medicare ID - Type UnspecifiedPROVIDER NUMBER
FLT85853Medicare UPIN