Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | ME0053719 | FL |
NPI | 1053426791 |
---|---|
Provider Name | Dr. Ranjith M Shetty |
First Address | New Port Richey, FL 34652-2536 |
Second Address | New Port Richey, FL 34652-2536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 11/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030001113 | R.R.MEDICARE (01) | FL |
063584700 | (05) | FL |
0818171 | AETNA (01) | FL |
212464001 | CIGNA (01) | FL |
AVMED | 218996 (01) | FL |
BC/BS | 10133 (01) | FL |
E49849 | (02) | FL |
GHI | 0099193 (01) | FL |