MEDICARE: SAILESH NARESH SHAH D.O.

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	OS9430	FL
2	207RP1001X	Pulmonary Disease Physician	OS9430	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00977996	OTHER	FL	RR MEDICARE

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	:	1437191244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAILESH NARESH SHAH D.O.

Provider Business Mailing Address
First Line	:	38135 MARKET SQ
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-7505
Country	:	US
Telephone Number	:	813-528-4975
Fax Number	:

Provider Business Practice Location Address
First Line	:	13311 N 56TH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-1161
Country	:	US
Telephone Number	:	813-284-2220
Fax Number	:	813-377-1718

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	08/27/2021

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