Healthcare Provider Details

I. General information

NPI: 1720098544
Provider Name (Legal Business Name): MILIND SHASTRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 HIGHWAY 41 N
INVERNESS FL
34453-2454
US

IV. Provider business mailing address

14690 SPRING HILL DR STE 305
SPRING HILL FL
34609-8102
US

V. Phone/Fax

Practice location:
  • Phone: 352-480-0560
  • Fax: 352-480-0565
Mailing address:
  • Phone: 352-277-5348
  • Fax: 352-606-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME78967
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: