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NPI Code Detail

MEDICARE: SUMEET SHETTY M.D.

MEDICARE: SUMEET SHETTY M.D.
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
1207R00000XInternal Medicine PhysicianME91067FL
2225400000XRehabilitation PractitionerME91067FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
248938OTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245319391
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUMEET SHETTY M.D.
Provider Business Mailing Address
First Line : 4820 GRIFFIN BLVD
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-2016
Country : US
Telephone Number : 239-208-6648
Fax Number : 855-462-3008
Provider Business Practice Location Address
First Line : 3050 CHAMPION RING RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-5599
Country : US
Telephone Number : 239-313-2901
Fax Number : 239-939-4811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 06/14/2023

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