MEDICARE: AJIT SHAH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	ME96817	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083617229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AJIT SHAH M.D.

Provider Business Mailing Address
First Line	:	10069 HART BRANCH CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-5913
Country	:	US
Telephone Number	:	407-282-8243
Fax Number	:

Provider Business Practice Location Address
First Line	:	10069 HART BRANCH CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-5913
Country	:	US
Telephone Number	:	407-282-8243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/28/2013

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