Healthcare Provider Details

I. General information

NPI: 1346720091
Provider Name (Legal Business Name): ARTI SHAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6820 GULFPORT BLVD S
SOUTH PASADENA FL
33707-2108
US

IV. Provider business mailing address

10033 S YACHT CLUB DR
TREASURE ISLAND FL
33706-3101
US

V. Phone/Fax

Practice location:
  • Phone: 727-345-9103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS57927
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: