MEDICARE: AMI M SHAH DO

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	207RR0500X	Rheumatology Physician	OS0018995	FL

General Provider Information

NPI Number	:	1144781428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMI M SHAH DO

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-532-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	4321 N MACDILL AVE STE 305
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6390
Country	:	US
Telephone Number	:	813-356-7161
Fax Number	:	813-356-7160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2019
Last Update Date	:	03/02/2026

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Directions to “ AMI M SHAH DO” Practice Location

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