Provider Demographics
NPI:1295785061
Name:SHAH, VRAJESHKUMAR (MD)
Entity type:Individual
Prefix:
First Name:VRAJESHKUMAR
Middle Name:
Last Name:SHAH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20615 AMBERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-4387
Mailing Address - Country:US
Mailing Address - Phone:813-960-4894
Mailing Address - Fax:813-968-4894
Practice Address - Street 1:15953 N FLORIDA AVE
Practice Address - Street 2:STONEWATER PROFESSIONAL PARK
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-8100
Practice Address - Country:US
Practice Address - Phone:813-960-4894
Practice Address - Fax:813-968-4894
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine