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Individual

ANJAN R SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
560 S LAKEWOOD DR STE 101, BRANDON, FL 33511-5016
(813) 978-9700
(813) 558-6434
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 558-6186

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME100905
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000065200
FL
01
30332
BLUECROSS BLUESHIELD
FL
01
316383
AVMED
FL
01
7794524
CIGNA
FL
01
9595150
AETNA
FL
Enumeration date
04/23/2008
Last updated
01/27/2020
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