Healthcare Provider Details

I. General information

NPI: 1831608496
Provider Name (Legal Business Name): COMPREHENSIVE RETINA CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2017
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13840 W NEWBERRY RD
NEWBERRY FL
32669-2094
US

IV. Provider business mailing address

6205 NW 81ST DR
GAINESVILLE FL
32653-2979
US

V. Phone/Fax

Practice location:
  • Phone: 352-775-1010
  • Fax: 352-559-1210
Mailing address:
  • Phone: 352-562-6058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME86573
License Number StateFL

VIII. Authorized Official

Name: DR. SHALESH KAUSHAL
Title or Position: OWNER
Credential: MD, PHD
Phone: 352-562-6058