Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shahab Rezvani, MD

Individual provider Internal Medicine Physician · NPI 1639589401

Shahab Rezvani, MD is a Diagnostic Radiology in Deland, Florida. Qualified in 2014, 12 years ago. Practices with Florida Hospital Medical Group Inc, a 329-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Florida, Kentucky and Michigan.

Years since qualifying
12
Licensed in
FL, KY, MI
In the registry since
2014
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

701 W Plymouth Ave
Deland, FL 32720-3236
Phone: (386) 943-3160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 4660 S Hagadorn Rd Ste 510, East Lansing, MI 48823-6805 — (517) 353-5053
  • 4660 S Hagadorn Rd Ste 410, East Lansing, MI 48823-6819 — (517) 353-5053
  • 3220 Discovery Dr Ste 100, Lansing, MI 48910-8609 — (517) 975-8930

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence ME145200 (FL)
Internal Medicine Physician Taxonomy 207R00000X · Licence 4301105203 (MI)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 55364 (KY)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 4301501046 (MI)

Record details

NPI number1639589401
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 2, 2014
Last updated in NPPESSeptember 24, 2024
Certification dateSeptember 24, 2024
Mailing address701 W Plymouth Ave, Deland, FL 32720-3236

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Florida Hospital Medical Group Inc — 329 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Deland