MEDICARE: DR. SASHA M DAVIDSON 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	207V00000X	Obstetrics & Gynecology Physician	D0067862	MD
2	207V00000X	Obstetrics & Gynecology Physician	MD037119	DC
3	207VM0101X	Maternal & Fetal Medicine Physician	01079464A	IN
4	207VM0101X	Maternal & Fetal Medicine Physician	ME127647	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	:	1407992167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SASHA M DAVIDSON M.D.

Provider Business Mailing Address
First Line	:	401 E LAS OLAS BLVD STE 130-415
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-2210
Country	:	US
Telephone Number	:	954-603-3933
Fax Number	:	954-603-3939

Provider Business Practice Location Address
First Line	:	2151 E COMMERCIAL BLVD STE 202
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3807
Country	:	US
Telephone Number	:	954-603-3933
Fax Number	:	954-603-3939

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	03/09/2020

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Directions to “ DR. SASHA M DAVIDSON M.D.” Practice Location

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