MEDICARE: VIRAL PANKAJ SHAH PHARMD

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	PS38128	FL

General Provider Information

NPI Number	:	1932625167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRAL PANKAJ SHAH PHARMD

Provider Business Mailing Address
First Line	:	5315 AVION PARK DR STE 120
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1461
Country	:	US
Telephone Number	:	727-209-5722
Fax Number	:	727-201-8923

Provider Business Practice Location Address
First Line	:	2708 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1837
Country	:	US
Telephone Number	:	813-932-6337
Fax Number	:	813-932-7455

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

Provider Enumeration Date	:	08/18/2017
Last Update Date	:	10/18/2019

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