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General NPI Number Information
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NPI Number | 1932632239
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Entity Type | Individual
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Provider Name | VIDHI SHAH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/04/2017
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 17222 HOSPITAL BLVD STE 346
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City | BROOKSVILLE
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State | FL
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Zip | 34601-8925
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Country | US
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Telephone | 352-796-3334
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Fax | 352-796-3323
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Provider Business Mailing Address
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Address Line | 17222 HOSPITAL BLVD STE 346
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City | BROOKSVILLE
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State | FL
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Zip | 34601-8925
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Country | US
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Telephone | 352-793-3334
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Fax | 352-796-3323
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 26382
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 149468
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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