Provider Demographics
NPI:1598544496
Name:SHINGALA, PARESHBHAI
Entity Type:Individual
Prefix:
First Name:PARESHBHAI
Middle Name:
Last Name:SHINGALA
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 1:1029 EMERALD HILL WAY
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-5168
Mailing Address - Country:US
Mailing Address - Phone:813-462-1055
Mailing Address - Fax:
Practice Address - Street 1:1029 EMERALD HILL WAY
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-5168
Practice Address - Country:US
Practice Address - Phone:813-462-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist