Individual
DR. MONA JAY SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11512 LAKE MEAD AVE UNIT 604, JACKSONVILLE, FL 32256-9686
(904) 717-3510
(904) 667-0101
Mailing address
11512 LAKE MEAD AVE UNIT 604, JACKSONVILLE, FL 32256-9686
(904) 717-3510
(904) 667-0101
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME94951
FL
207UN0901X
Nuclear Cardiology Physician
ME94951
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275142900
—
FL
01
—
P01133944
RAILROAD MEDICARE
FL
Enumeration date
05/05/2006
Last updated
01/02/2025
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