Shaw at Palmetto Bay Corp

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SHAW AT PALMETTO BAY CORP

Practice address

15904 SW 92ND Ave
Palmetto Bay, FL 33157-1842

Phone

(954) 446-5440

NPI assigned

Jan 21, 2025

Organization subpart

No

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

Authorized official

Name

Jesse H Shaw, MD

Title

President

Phone

(954) 446-5440

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1912719675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15904 SW 92ND AVE",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571842",
            "telephone_number": "954-446-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15904 SW 92ND AVE",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571842",
            "telephone_number": "954-446-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAW AT PALMETTO BAY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-446-5440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Palmetto Bay, FL
• Providers in Palmetto Bay, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.