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SANJIV SHAH MD LLC - Florida Company Profile

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Company Details

Entity Name: SANJIV SHAH MD LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 11 Feb 2025 (7 months ago)
Document Number: L25000072126
Address: 3615 WEST SHADOW CREEK LOOP, LECANTO, FL, 34461
Mail Address: 3615 W. SHADOW CREEK LOOP, LECANTO, FL, 34461, US
ZIP code: 34461
City: Lecanto
County: Citrus
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
SHAH SANJIV Agent 3615 W. SHADOW CREEK LOOP, LECANTO, FL, 34461
SHAH SANJIV Manager 3615 WEST SHADOW CREEK LOOP, LECANTO, FL, 34461

National Provider Identifier

NPI Number:
1881498921
Certification Date:
2025-04-01

Authorized Person:

Name:
SANJIV ISHVERLAL SHAH
Role:
OWNER/MD/PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207RN0300X - Nephrology Physician
Is Primary:
Yes

Contacts:

Fax:
7862208715

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Date of last update: 02 Aug 2025

Sources: Florida Department of State