Individual
HEMANT SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3306 US HIGHWAY 19, HOLIDAY, FL 34691-1846
(727) 849-6850
Mailing address
PO BOX 21727, TAMPA, FL 33622-1727
(727) 823-2188
(727) 828-0723
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME0063553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00430
UNIVERSAL
FL
01
—
104183
AVMED
FL
01
—
110130899
RAILROAD MEDICARE
FL
01
—
201978
AMERIGROUP
FL
01
—
26263
BCBS
FL
01
—
26992
WELLCARE
FL
01
—
26992
WELLCARE
—
05
—
379627201
—
FL
01
—
6011235
GHI
FL
01
—
ME63553
WORK COMP
FL
01
—
PCP0066
QUALITY HEALTH PLAN
FL
Enumeration date
08/03/2006
Last updated
12/30/2020
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