Provider Demographics
NPI:1881088037
Name:SHAH, MONISHA (MD)
Entity type:Individual
Prefix:DR
First Name:MONISHA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MONISHA
Other - Middle Name:
Other - Last Name:PARIKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18934 N DALE MABRY HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4914
Mailing Address - Country:US
Mailing Address - Phone:813-948-2679
Mailing Address - Fax:
Practice Address - Street 1:18934 N DALE MABRY HWY STE 101
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4914
Practice Address - Country:US
Practice Address - Phone:813-948-2679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics