Individual
BISMA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
901 S STATE ROAD 7, PLANTATION, FL 33317-4522
(754) 200-8803
Mailing address
20046 NW 66TH PL, HIALEAH, FL 33015-2139
(305) 336-0447
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112065
FL
363AM0700X
Medical Physician Assistant
1160980
FL
Other
Enumeration date
08/07/2019
Last updated
12/21/2024
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