Provider Demographics
NPI:1922552272
Name:SHAH, NINA N (DO)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:N
Last Name:SHAH
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:11425 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-1439
Practice Address - Country:US
Practice Address - Phone:727-339-0430
Practice Address - Fax:352-616-0965
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2023-11-03
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Provider Licenses
StateLicense IDTaxonomies
FLOS16200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104556100Medicaid