Provider Demographics
NPI:1285950931
Name:IMANO, SHAHEEDAH MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHEEDAH
Middle Name:MARIE
Last Name:IMANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHAHEEDAH
Other - Middle Name:MARIE
Other - Last Name:CANTLEY MUHAMMAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8850 NW 37TH DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3081
Mailing Address - Country:US
Mailing Address - Phone:602-402-9586
Mailing Address - Fax:
Practice Address - Street 1:2964 N STATE ROAD 7 STE 300
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5715
Practice Address - Country:US
Practice Address - Phone:954-468-3080
Practice Address - Fax:954-468-3082
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMD456651207V00000X
FLME141612207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology