Shane Yasin Farouk, MSN, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11050249 Issued in FL

Practice address

1201 N 37TH Ave Ste 100
Hollywood, FL 33021-5414

Phone

(754) 777-5600

NPI assigned

Aug 22, 2026

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Haxmon Medical Services P LLC LLC

  • Addiction Medicine (Family Medicine) Physician
  • Hollywood, FL
  • NPI 1346975752
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1787356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787356800000",
    "number": "1740196344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N 37TH AVE STE 100",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215414",
            "telephone_number": "754-777-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N 37TH AVE STE 100",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215414",
            "telephone_number": "754-777-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAROUK",
        "first_name": "SHANE",
        "middle_name": "YASIN",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-22",
        "last_updated": "2026-08-22",
        "certification_date": "2026-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11050249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faris a. Hanna, MD, PA
• Lisa Farkas, MS, RDN, LDN, CDCES
• Veronique Farnault, L.M.T.
• Brigitte Elizabeth Farnsworth, FNP
• Shama Unissa Faroqui, MS.
• Daniela Farr
• Andrew Ryan Farretta, L.M.T.
• Dennis Paul Farretta, L.M.T.
• Hossein Farsad, M.D.
• Awvean Farshadi

• Psychiatric/Mental Health Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.