Healthcare Provider Details

I. General information

NPI: 1750514154
Provider Name (Legal Business Name): UMANG LALIT SHAH M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 MICHIGAN ST
LAKE MARY FL
32746-4602
US

IV. Provider business mailing address

3434 MICHIGAN ST
LAKE MARY FL
32746-4602
US

V. Phone/Fax

Practice location:
  • Phone: 865-230-2827
  • Fax:
Mailing address:
  • Phone: 865-230-2827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME140253
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD2025-1174
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME140253
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberME140253
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: