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General NPI Number Information
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NPI Number | 1831608496
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE RETINA CONSULTANTS PLLC
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 13840 W NEWBERRY RD
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City | NEWBERRY
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State | FL
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Zip | 32669-2094
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Country | US
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Telephone | 352-775-1010
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Fax | 352-559-1210
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Provider Business Mailing Address
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Address Line | 6205 NW 81ST DR
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City | GAINESVILLE
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State | FL
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Zip | 32653-2979
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Country | US
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Telephone | 352-562-6058
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHALESH KAUSHAL
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Credential | MD, PHD
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Telephone | 352-562-6058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | ME86573
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License Number State | FL
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