Provider Demographics
NPI:1427476563
Name:SHIM, STEPHANIE SORA (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SORA
Last Name:SHIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 ALTON RD STE 220
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2818
Mailing Address - Country:US
Mailing Address - Phone:305-674-2090
Mailing Address - Fax:305-674-2903
Practice Address - Street 1:4302 ALTON RD STE 220
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2818
Practice Address - Country:US
Practice Address - Phone:305-674-2090
Practice Address - Fax:305-674-2903
Is Sole Proprietor?:No
Enumeration Date:2014-04-05
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA279163207X00000X, 207XS0106X
FLME146009207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery