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General NPI Number Information
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NPI Number | 1295785061
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Entity Type | Individual
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Provider Name | VRAJESHKUMAR SHAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 15953 N FLORIDA AVE STONEWATER PROFESSIONAL PARK
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City | LUTZ
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State | FL
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Zip | 33549-8100
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Country | US
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Telephone | 813-960-4894
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Fax | 813-968-4894
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Provider Business Mailing Address
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Address Line | 20615 AMBERFIELD DR
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City | LAND O LAKES
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State | FL
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Zip | 34638-4387
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Country | US
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Telephone | 813-960-4894
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Fax | 813-968-4894
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0061405
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License Number State | FL
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