Provider Demographics
NPI:1053636324
Name:SATAHOO, SHEVONNE SASHA LEE (MD)
Entity Type:Individual
Prefix:
First Name:SHEVONNE
Middle Name:SASHA LEE
Last Name:SATAHOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEVONNE
Other - Middle Name:SASHA LEE
Other - Last Name:SATAHOO-DAWES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1850 NW 9TH ST STE T242
Mailing Address - Street 2:DEPARTMENT OF SURGERY
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3544
Mailing Address - Country:US
Mailing Address - Phone:305-585-1280
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-1280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME1414622086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program