Active NPI
Shai Shabtai Libson
- Student in an Organized Health Care Education/Training Program
- Miami, FL
National Provider Identifier
1790064715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- TRN16415
- Practice address
- 1611 NW 12TH Ave
Miami, FL 33136-1005 - Phone
- (305) 243-8787
- NPI assigned
- Aug 8, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TRN16415 | FL | Primary |
Addresses
Primary practice location
1611 NW 12TH Ave
Miami, FL 33136-1005
Mailing address
1035 NE 179TH Ter
North Miami Beach, FL 33162-1256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN16415 | FL | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312761600000",
"number": "1790064715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 NE 179TH TER",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331621256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-243-8787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBSON",
"first_name": "SHAI",
"middle_name": "SHABTAI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-08",
"last_updated": "2011-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "TRN16415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.