Individual
RAJESH A SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
251 MAITLAND AVE, SUITE 116, ALTAMONTE SPRINGS, FL 32701-4914
(407) 915-5643
(407) 960-2602
Mailing address
PO BOX 940145, MAITLAND, FL 32794-0145
(407) 915-5643
(407) 960-2602
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME96007
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME96007
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014023900
—
FL
01
—
145XP
BCBS OF FL
FL
01
—
ME96007
MEDICAL LICENSE
FL
Enumeration date
07/26/2006
Last updated
02/05/2020
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