MEDICARE: MR. URMIL SHAH RPH

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	183500000X	Pharmacist	30414	NC
2	183500000X	Pharmacist	28RI02926400	NJ
3	183500000X	Pharmacist	16804	MD
4	183500000X	Pharmacist	PS54730	FL

General Provider Information

NPI Number	:	1467508192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. URMIL SHAH RPH

Provider Business Mailing Address
First Line	:	1550 SE FLORESTA DR
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-4069
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 SE FLORESTA DR
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-4069
Country	:	US
Telephone Number	:	772-340-4142
Fax Number	:	772-785-5753

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	06/29/2021

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Directions to “ MR. URMIL SHAH RPH” Practice Location

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