Individual
DR. ATUL MUKUTBHAI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6310 BEACH BLVD, JACKSONVILLE, FL 32216-2708
(904) 725-6463
(904) 724-5006
Mailing address
6310 BEACH BLVD, JACKSONVILLE, FL 32216-2708
(904) 725-6463
(904) 724-5006
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME0048902
FL
2084P0800X
Psychiatry Physician
Primary
ME48902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043765400
—
FL
Enumeration date
03/17/2006
Last updated
02/24/2020
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