Individual
SAURIN JAYENDRA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP ANESTHESIOLOGY, JACKSONVILLE, FL 32209-6511
(904) 244-4195
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
26112
AL
207L00000X
Anesthesiology Physician
Primary
ME103324
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009971035
—
AL
05
—
009971045
—
AL
05
—
009971055
—
AL
01
—
010033CI21369
SECTION 1011
AL
01
—
051524787
BLUE CROSS
AL
01
—
051524788
BLUE CROSS
AL
01
—
051524824
BLUE CROSS
AL
01
—
4901341
MISSISSIPPI MEDICAID
MS
05
—
852995576A
—
GA
01
—
P00167065
RAILROAD MEDICARE
AL
Enumeration date
07/17/2006
Last updated
05/04/2010
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