Individual
MANISH ASHOK SHAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
42658
AL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
ME176105
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0IRLH
BCBS
FL
Enumeration date
04/07/2016
Last updated
11/15/2025
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