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NPI Code Detail

MEDICARE: SHRUTI DOSI DPM

MEDICARE: SHRUTI DOSI DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristPO4146FL
2213EP0504XPublic Medicine PodiatristPO4146FL
3213EP1101XPrimary Podiatric Medicine PodiatristPO4146FL
4213ES0000XSports Medicine PodiatristPO4146FL
5213ES0103XFoot & Ankle Surgery Podiatrist213E00000XGA
6213ES0131XFoot Surgery PodiatristPO4146FL
7213ES0103XFoot & Ankle Surgery PodiatristPO4146FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115165159OTHERCAQH ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3PRLE4OTHERFLBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083110571
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHRUTI DOSI DPM
Provider Business Mailing Address
First Line : 1307 S INTERNATIONAL PKWY STE 1061
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-1412
Country : US
Telephone Number : 407-323-1234
Fax Number :
Provider Business Practice Location Address
First Line : 1307 S INTERNATIONAL PKWY STE 1061
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-1412
Country : US
Telephone Number : 407-323-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2018
Last Update Date : 10/27/2023

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Directions to “ SHRUTI DOSI DPM” Practice Location

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