Provider Demographics
NPI:1144212770
Name:SHAH, NEERAV S (MD)
Entity Type:Individual
Prefix:DR
First Name:NEERAV
Middle Name:S
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-0939
Mailing Address - Country:US
Mailing Address - Phone:561-793-6100
Mailing Address - Fax:561-793-1974
Practice Address - Street 1:3347 STATE ROAD 7
Practice Address - Street 2:STE 203
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8095
Practice Address - Country:US
Practice Address - Phone:561-793-6100
Practice Address - Fax:561-793-1974
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME79386207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268241900Medicaid
FL268241900Medicaid
H94253Medicare UPIN
FLU1333ZMedicare Oscar/Certification