MEDICARE: MONA SHAH, MD, LLC

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	2083P0901X	Public Health & General Preventive Medicine Physician

General Provider Information

NPI Number	:	1962344994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONA SHAH, MD, LLC

Provider Business Mailing Address
First Line	:	PO BOX 18842
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33679-8842
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2919 W SWANN AVE STE 303
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4051
Country	:	US
Telephone Number	:	813-445-3140
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MONA SHAH
Credential	:	MD
Telephone Number	:	813-445-3140

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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