MEDICARE: SWATI SHAH, MD RHEUMATOLOGY LLC

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	332900000X	Non-Pharmacy Dispensing Site
2	207RR0500X	Rheumatology Physician

General Provider Information

NPI Number	:	1437092889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWATI SHAH, MD RHEUMATOLOGY LLC

Provider Business Mailing Address
First Line	:	9765 SAN JOSE BLVD STE 103
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5467
Country	:	US
Telephone Number	:	904-517-8222
Fax Number	:	904-517-1222

Provider Business Practice Location Address
First Line	:	9765 SAN JOSE BLVD STE 103
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5467
Country	:	US
Telephone Number	:	904-517-8222
Fax Number	:	904-517-1222

Authorized Official
Title or Position	:	OWNER
Name	:	SWATI SHAH
Credential	:	MD
Telephone Number	:	904-517-8222

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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