Healthcare Provider Details

I. General information

NPI: 1578762688
Provider Name (Legal Business Name): AEISHA KEKHIA STIMAGE RIVERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AEISHA KEKHIA STIMAGE MD

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 NW 12TH AVE
MIAMI FL
33136-1002
US

IV. Provider business mailing address

1475 NW 12TH AVE
MIAMI FL
33136-1002
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-5302
  • Fax: 305-243-4907
Mailing address:
  • Phone: 305-243-5302
  • Fax: 305-243-4907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME132591
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: