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General NPI Number Information
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NPI Number | 1780147934
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Entity Type | Individual
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Provider Name | KEVIN SHAH
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Gender | Male
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 5651 49TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33709-2105
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Country | US
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Telephone | 727-443-4299
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-343-6202
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Fax | 239-343-4159
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME172716
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME172716
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License Number State | FL
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