MEDICARE: MARISSA KATHERINE SHOJI

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	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	ME176802	FL

General Provider Information

NPI Number	:	1265096929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA KATHERINE SHOJI

Provider Business Mailing Address
First Line	:	900 NW 17TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1119
Country	:	US
Telephone Number	:	305-243-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 NW 12TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1005
Country	:	US
Telephone Number	:	305-326-6000
Fax Number	:

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

Provider Enumeration Date	:	04/29/2019
Last Update Date	:	12/09/2025

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Directions to “ MARISSA KATHERINE SHOJI ” Practice Location

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