MEDICARE: SHREYA BHANDARI OD

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
1	152W00000X	Optometrist	OPC5956	FL

General Provider Information

NPI Number	:	1477124600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHREYA BHANDARI OD

Provider Business Mailing Address
First Line	:	12731 NEW BRITTANY BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3632
Country	:	US
Telephone Number	:	239-215-6931
Fax Number	:

Provider Business Practice Location Address
First Line	:	3515 DEL PRADO BLVD S STE 104
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-7289
Country	:	US
Telephone Number	:	239-418-0999
Fax Number	:	239-274-0773

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2021
Last Update Date	:	07/08/2021

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