Healthcare Provider Details

I. General information

NPI: 1235328618
Provider Name (Legal Business Name): SHEETAL KUMAR,M.D. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 07/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SE FEDERAL HWY
STUART FL
34994-3821
US

IV. Provider business mailing address

1000 SE FEDERAL HWY
STUART FL
34994-3821
US

V. Phone/Fax

Practice location:
  • Phone: 772-219-2500
  • Fax: 772-463-4677
Mailing address:
  • Phone: 772-219-2500
  • Fax: 772-463-4677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME78776
License Number StateFL

VIII. Authorized Official

Name: DR. SHEETAL KUMAR
Title or Position: OWNER/MEDICAL DOCTOR
Credential: M.D. PA
Phone: 772-219-2500