Shah Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS10163 Issued in FL

Legal business name

SHAH DERMATOLOGY LLC

Practice address

201 Hilda St
Suite 38
Kissimmee, FL 34741-2320

Phone

(407) 629-8865

Fax

(407) 629-8932

NPI assigned

May 15, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ayyaz M Shah, DO

Title

President

Phone

(407) 629-8865

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1669818845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HILDA ST",
            "address_2": "SUITE 38",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412320",
            "telephone_number": "407-629-8865",
            "fax_number": "407-629-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HILDA ST",
            "address_2": "SUITE 38",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412320",
            "telephone_number": "407-629-8865",
            "fax_number": "407-629-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAH DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "AYYAZ",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-629-8865",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS10163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Sewnarine
• SF Kissimmee LLC
• Sga Healthcare LLC
• SGL Arnaldi Case Management Services LLC
• Shady Pines Assisted Living Facility LLC
• Bindi Shah, LMHC
• Raj Shah
• Shailesh Shah, M.D.
• Fuad H Shahin, M.D.
• Naushad Abdul Salam Shaik, MD

• Dermatology Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.