Individual
DR. BHAVESH A. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1921 WALDEMERE ST STE 405, SARASOTA, FL 34239-2941
(941) 917-3500
(941) 917-3501
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-101053
IL
207Q00000X
Family Medicine Physician
Primary
ME145449
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
920540
MEDICARE PTAN GROUP
IL
01
—
F400268164
MEDICARE PTAN INDIVIDUAL
IL
Enumeration date
11/14/2006
Last updated
07/06/2020
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