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Individual

JAYESH S SHAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1426 W BUSCH BLVD STE 105, TAMPA, FL 33612-7648
(813) 935-0222
(813) 877-6330
Mailing address
1426 W BUSCH BLVD STE 105, TAMPA, FL 33612-7648
(813) 935-0222
(813) 877-6330

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME62438
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00128
WELLCARE & HEALTHEASE
FL
01
00700
UNIVERSAL
FL
01
202573
AMERIGROUP
FL
01
205996
AVMED
05
370960400
FL
01
6009848
GHI
01
BCBS
17903
FL
01
P00477293
RAILROAD MEDICARE
Enumeration date
08/19/2006
Last updated
05/12/2020
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