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General NPI Number Information
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NPI Number | 1881349975
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Entity Type | Individual
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Provider Name | KRISHA SHAH PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 3500 E FLETCHER AVE STE 400
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City | TAMPA
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State | FL
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Zip | 33613-4719
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Country | US
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Telephone | 813-580-5479
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Fax | 813-954-7530
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Provider Business Mailing Address
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Address Line | 128 STONEBRIAR BLVD
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City | JUPITER
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State | FL
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Zip | 33458-8153
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9115729
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License Number State | FL
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