Organization
CITRUS PARK MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIPAK SHAH M.D. (DOCTOR)
(813) 343-5500
Entity
Organization
Contact information
Practice address
6328 GUNN HWY, TAMPA, FL 33625-4122
(813) 343-5500
Mailing address
6328 GUNN HWY, TAMPA, FL 33625-4122
(813) 343-5500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME50876
FL
207R00000X
Internal Medicine Physician
Primary
ME50876
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00291
STAYWELL
FL
01
—
03966
BCBS
FL
01
—
04953
UNIVERSAL MEDICAL
FL
01
—
206018
AVMED
FL
01
—
228737
AMERIGROUP
FL
Enumeration date
05/14/2007
Last updated
09/11/2025
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