Individual
DR. SHREE JAYENDRA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1621 CARIBBEAN DR, SARASOTA, FL 34231-5305
(941) 914-6118
Mailing address
22100 BOTHELL EVERETT HWY, BOTHELL, WA 98021-8431
(208) 416-2932
(855) 673-9190
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101266871
VA
2085R0202X
Diagnostic Radiology Physician
Primary
95952
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276110600
—
FL
01
—
56438
BLUE CROSS OF FLORIDA
FL
01
—
P00360870
SMH RR MEDICARE
FL
Enumeration date
07/27/2006
Last updated
08/30/2023
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