Provider Demographics
NPI:1114056728
Name:CHAH, SHAMAYA (LMT)
Entity Type:Individual
Prefix:MS
First Name:SHAMAYA
Middle Name:
Last Name:CHAH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 CACTUS LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-5200
Mailing Address - Country:US
Mailing Address - Phone:352-357-6575
Mailing Address - Fax:352-357-6575
Practice Address - Street 1:2105 PREVATT ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6131
Practice Address - Country:US
Practice Address - Phone:352-357-6575
Practice Address - Fax:352-357-6575
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 4338225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist