MEDICARE: RAJANI P. SHAH, MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0071862	FL

General Provider Information

NPI Number	:	1134235120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAJANI P. SHAH, MD PA

Provider Business Mailing Address
First Line	:	10311 CROSS CREEK BLVD
Second Line	:	SUITE B
City	:	TAMPA
State	:	FL
Zip	:	33647-2989
Country	:	US
Telephone Number	:	813-994-7670
Fax Number	:	813-994-7640

Provider Business Practice Location Address
First Line	:	10311 CROSS CREEK BLVD
Second Line	:	SUITE B
City	:	TAMPA
State	:	FL
Zip	:	33647-2989
Country	:	US
Telephone Number	:	813-994-7670
Fax Number	:	813-994-7640

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RAJANI P. SHAH
Credential	:	M.D.
Telephone Number	:	813-994-7670

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	10/18/2014

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