Provider Demographics
NPI:1932550993
Name:BENASRIE, SHAMA
Entity Type:Individual
Prefix:MRS
First Name:SHAMA
Middle Name:
Last Name:BENASRIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6270 NW 18TH PL
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-4619
Mailing Address - Country:US
Mailing Address - Phone:954-648-9363
Mailing Address - Fax:
Practice Address - Street 1:6270 NW 18TH PL
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-4619
Practice Address - Country:US
Practice Address - Phone:954-648-9363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other