# DOC AESTHETICS.LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275354128
- **Authorized official:** CHINTAN SHAH MD (PROVIDER)
- **Authorized official phone:** (772) 302-3767

## Contact information

- **Practice address:** 2215 NEBRASKA AVE, STE 2B, FORT PIERCE, FL 34950-4867
- **Practice address phone:** (772) 302-3767
- **Mailing address:** 2215 NEBRASKA AVE, STE 2B, FORT PIERCE, FL 34950

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2024
- **Last updated:** 10/23/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 006739300 | — | FL |