Provider Demographics
NPI:1851508857
Name:WIERS-SHAMIR, KRISTINA M (MD)
Entity Type:Individual
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First Name:KRISTINA
Middle Name:M
Last Name:WIERS-SHAMIR
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:900 GLADES RD STE 501
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6421
Practice Address - Country:US
Practice Address - Phone:954-265-3030
Practice Address - Fax:954-265-3065
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2021-03-17
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Provider Licenses
StateLicense IDTaxonomies
FLME1018002080P0216X, 2080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000345100Medicaid