MEDICARE: SHEFALI MEHTA

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	207L00000X	Anesthesiology Physician	125.071065	IL
2	207L00000X	Anesthesiology Physician	ME158069	FL

General Provider Information

NPI Number	:	1285164335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEFALI MEHTA

Provider Business Mailing Address
First Line	:	1535 BAY DR
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-4716
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 JOE DIMAGGIO DR
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5487
Country	:	US
Telephone Number	:	954-265-5324
Fax Number	:

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

Provider Enumeration Date	:	06/12/2017
Last Update Date	:	08/04/2023

Similar Medicare Providers

1306702063 — KELLI RENEE GARNER DNP, CRNA
Practice Location Address:

1005 JOE DIMAGGIO DR
HOLLYWOOD, FL
33021-5487

Practice Phone: 954-939-5000
Practice Fax:

1558672303 — DR. DANIEL RUSSEL BETTERLY MD
Practice Location Address:

3501 JOHNSON STREET
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1780929745 — DR. ZACHARY AUSTIN WICHNER D.O., MPH
Practice Location Address:

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HOLLYWOOD, FL
33021-5487

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Practice Fax:

1902250483 — MARIELA ODALISSE SANCHEZ ROSADO MD
Practice Location Address:

1005 JOE DIMAGGIO DR APT 1704
HOLLYWOOD, FL
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Practice Fax:

1629509302 — NATHANIEL HAMILTON FORMAN M.D.
Practice Location Address:

1005 JOE DIMAGGIO DR
HOLLYWOOD, FL
33021-5487

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1699209965 — DR. JONATHAN NEAL RUNYON MD
Practice Location Address:

1005 JOE DIMAGGIO DR
HOLLYWOOD, FL
33021-5487

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Directions to “ SHEFALI MEHTA ” Practice Location

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