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General NPI Number Information
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NPI Number | 1477787638
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Entity Type | Individual
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Provider Name | SHRUTI NIKETAN TEWAR M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2009
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 2435 LEE RD
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City | WINTER PARK
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State | FL
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Zip | 32789-1755
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Country | US
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Telephone | 407-564-3375
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Fax | 407-564-3379
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Provider Business Mailing Address
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Address Line | 2435 LEE RD
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City | WINTER PARK
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State | FL
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Zip | 32789-1755
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Country | US
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Telephone | 407-564-3375
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Fax | 407-564-3379
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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 | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | ME171901
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | E-13828
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License Number State | AR
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