Provider Demographics
NPI:1649456971
Name:SHAH, FALGUNI (DPT)
Entity type:Individual
Prefix:DR
First Name:FALGUNI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 ISLEBAY DR
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3331
Mailing Address - Country:US
Mailing Address - Phone:248-767-7832
Mailing Address - Fax:
Practice Address - Street 1:3248 LITHIA PINECREST RD STE 102
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5682
Practice Address - Country:US
Practice Address - Phone:813-662-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008646225100000X
FLPT18789225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650H200400OtherBLUE CROSS BLUE SHIELD