Provider Demographics
NPI:1164750469
Name:SHAH, ARPIT M
Entity Type:Individual
Prefix:MR
First Name:ARPIT
Middle Name:M
Last Name:SHAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 PECAN PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4555
Mailing Address - Country:US
Mailing Address - Phone:904-993-6824
Mailing Address - Fax:407-956-4966
Practice Address - Street 1:4109 CRILL AVE
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-8559
Practice Address - Country:US
Practice Address - Phone:386-385-3838
Practice Address - Fax:386-385-3628
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist