Healthcare Provider Details

I. General information

NPI: 1881088037
Provider Name (Legal Business Name): MONISHA SHAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONISHA PARIKH MD

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18934 N DALE MABRY HWY STE 101
LUTZ FL
33548-4914
US

IV. Provider business mailing address

18934 N DALE MABRY HWY STE 101
LUTZ FL
33548-4914
US

V. Phone/Fax

Practice location:
  • Phone: 813-948-2679
  • Fax:
Mailing address:
  • Phone: 813-948-2679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number294658
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME171435
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: