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General NPI Number Information
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NPI Number | 1053426791
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Entity Type | Individual
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Provider Name | RANJITH M SHETTY M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 5307 MAIN ST SUITE # 201
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2536
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Country | US
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Telephone | 727-841-8876
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Fax | 727-843-8508
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Provider Business Mailing Address
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Address Line | 5307 MAIN ST SUITE # 201
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2536
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Country | US
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Telephone | 727-841-8876
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Fax | 727-843-8508
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | ME0053719
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License Number State | FL
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