MEDICARE: DR. SHANLEE STEVENS CORA MD

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	170937	NY
2	207W00000X	Ophthalmology Physician	170937	FL
3	207W00000X	Ophthalmology Physician	320964	NY
4	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	170937	FL

General Provider Information

NPI Number	:	1528624459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANLEE STEVENS CORA MD

Provider Business Mailing Address
First Line	:	1828 W HILLSBORO BLVD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-1400
Country	:	US
Telephone Number	:	954-421-8000
Fax Number	:	954-426-4400

Provider Business Practice Location Address
First Line	:	1828 W HILLSBORO BLVD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-1400
Country	:	US
Telephone Number	:	954-421-8000
Fax Number	:	954-426-4400

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

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	11/14/2025

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