MEDICARE: DR. SAMIR RAMESHCHANDRA SHAH M.D.

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	208600000X	Surgery Physician	38018	SC
2	208C00000X	Colon & Rectal Surgery Physician	38018	SC
3	208D00000X	General Practice Physician	ME140999	FL
4	208C00000X	Colon & Rectal Surgery Physician	ME140999	FL

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	:	1881893741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMIR RAMESHCHANDRA SHAH M.D.

Provider Business Mailing Address
First Line	:	9500 S DADELAND BLVD STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-2866
Country	:	US
Telephone Number	:	305-468-4185
Fax Number	:	305-596-3073

Provider Business Practice Location Address
First Line	:	5803 NW 151ST ST STE 105
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2473
Country	:	US
Telephone Number	:	305-596-3080
Fax Number	:	305-596-3073

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

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	02/01/2023

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Directions to “ DR. SAMIR RAMESHCHANDRA SHAH M.D.” Practice Location

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