Individual
MRS. LATA S SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HIS NBC
Contact information
Practice address
123 S INDUSTRIAL DR STE 101, ORANGE CITY, FL 32763-7421
(386) 775-8960
(386) 775-3757
Mailing address
123 S INDUSTRIAL DR STE 101, ORANGE CITY, FL 32763-7421
(386) 775-8960
(386) 775-3757
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS2790
FL
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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