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General NPI Number Information
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NPI Number | 1043680770
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Entity Type | Organization
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Legal Business Name | SHUSTER EYE PA
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Dates
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Enumeration Date | 10/07/2015
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Last Update Date | 10/07/2015
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Provider Practice Location Address
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Address Line | 2220 SE OCEAN BLVD SUITE 101
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City | STUART
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State | FL
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Zip | 34996-3301
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Country | US
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Telephone | 772-210-7070
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Fax | 772-210-9080
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Provider Business Mailing Address
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Address Line | 2220 SE OCEAN BLVD SUITE 101
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City | STUART
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State | FL
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Zip | 34996-3301
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Country | US
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Telephone | 772-210-7070
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Fax | 772-210-9080
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Authorized Official
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Title or Position | OWNER
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Name | ALAN R SHUSTER
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Credential | MD
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Telephone | 772-210-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME55016
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License Number State | FL
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