MEDICARE: STEPHANIE SORA SHIM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	279163	MA
2	207X00000X	Orthopaedic Surgery Physician	ME146009	FL
3	207XS0106X	Orthopaedic Hand Surgery Physician	279163	MA
4	207XS0106X	Orthopaedic Hand Surgery Physician	ME146009	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427476563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SORA SHIM M.D.

Provider Business Mailing Address
First Line	:	4302 ALTON RD STE 220
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2818
Country	:	US
Telephone Number	:	305-674-2090
Fax Number	:	305-674-2903

Provider Business Practice Location Address
First Line	:	4302 ALTON RD STE 220
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2818
Country	:	US
Telephone Number	:	305-674-2090
Fax Number	:	305-674-2903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2014
Last Update Date	:	08/04/2020

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Directions to “ STEPHANIE SORA SHIM M.D.” Practice Location

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