Provider Demographics
NPI:1447512322
Name:SHAW, SARA BETH (RT)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:BETH
Last Name:SHAW
Suffix:
Gender:F
Credentials:RT
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:BETH
Other - Last Name:MARTIN MCKENZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RT
Mailing Address - Street 1:16521 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6001
Mailing Address - Country:US
Mailing Address - Phone:305-947-7261
Mailing Address - Fax:305-945-9890
Practice Address - Street 1:16521 NW 1ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6001
Practice Address - Country:US
Practice Address - Phone:305-947-7261
Practice Address - Fax:305-945-9890
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT10893227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered