Provider Demographics
NPI:1164663332
Name:SHAH, NEAL (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3818 W VASCONIA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8630
Mailing Address - Country:US
Mailing Address - Phone:863-732-7246
Mailing Address - Fax:863-256-2520
Practice Address - Street 1:2310 NORTH BLVD W STE A
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-8988
Practice Address - Country:US
Practice Address - Phone:863-732-7246
Practice Address - Fax:863-256-2520
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME121272207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine