Healthcare Provider Details

I. General information

NPI: 1942192364
Provider Name (Legal Business Name): SHUBH PODIATRY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 N STATE ROAD 434 STE B
ALTAMONTE SPRINGS FL
32714-7014
US

IV. Provider business mailing address

840 N STATE ROAD 434 STE B
ALTAMONTE SPRINGS FL
32714-7014
US

V. Phone/Fax

Practice location:
  • Phone: 863-529-5576
  • Fax:
Mailing address:
  • Phone: 863-529-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NEIL JAYESH JANI
Title or Position: DIRECTOR
Credential: DPM
Phone: 863-529-5576