Organization
CHANDRAKANT SHAH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANDRAKANT S SHAD MD (PRESIDENT)
(305) 382-4901
Entity
Organization
Contact information
Practice address
13033 SW 112TH ST, MIAMI, FL 33186-4601
(305) 382-4901
(305) 382-4502
Mailing address
13033 SW 112TH ST, MIAMI, FL 33186-4601
(305) 382-4901
(305) 382-4502
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0061676
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058773703
—
FL
01
—
14792
MEDICARE ID
FL
Enumeration date
07/24/2008
Last updated
08/26/2008
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