Basic Information
| Provider Information | |||||||||
| NPI: | 1346329349 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LALIT K SHAH MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 39557 | ||||||||
| Address2: | |||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333399998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547763104 | ||||||||
| FaxNumber: | 9549584853 | ||||||||
| Practice Location | |||||||||
| Address1: | 4725 NORTH FEDERAL HWY | ||||||||
| Address2: | NICU 2ND FLOOR HOLY CROSS HOSPITAL | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333084603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547763104 | ||||||||
| FaxNumber: | 9549584853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SHAH | ||||||||
| AuthorizedOfficialFirstName: | LALIT | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9547763104 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.