Individual
TECRESHA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
104 NW 145TH ST, MIAMI, FL 33168-4930
(305) 807-1943
Mailing address
104 NW 145TH ST, MIAMI, FL 33168-4930
(305) 807-1943
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9108150
FL
Other
Enumeration date
04/09/2015
Last updated
04/09/2015
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