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4762 Rowan Rd New Port Richey FL 34653-5601 | |
| (727) 848-0800 | |
| (727) 843-8157 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 4762 Rowan Rd, New Port Richey, Florida |
| Authorized Official Name and Position | Siddharth H Shah (PRESIDENT) |
| Authorized Official Contact | 7278480800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 768 Elfers FL 34680-0768 Ph: (727) 848-0800 | 4762 Rowan Rd New Port Richey FL 34653-5601 Ph: (727) 848-0800 |
| NPI Number | 1952462350 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 06/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952462350 | NPI | - | NPPES |
| 256701600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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