MEDICARE: JHARNA PATEL SHAH MD

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	207R00000X	Internal Medicine Physician	A179805	CA
2	207R00000X	Internal Medicine Physician	V9130	TX

General Provider Information

NPI Number	:	1417417395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JHARNA PATEL SHAH MD

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	407-533-6836
Fax Number	:	407-770-0661

Provider Business Practice Location Address
First Line	:	1911 ROGERS RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4614
Country	:	US
Telephone Number	:	210-523-9933
Fax Number	:	210-647-0242

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

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	03/26/2026

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