Individual
SHRUTI DOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1307 S INTERNATIONAL PKWY STE 1061, LAKE MARY, FL 32746-1412
(407) 323-1234
Mailing address
1307 S INTERNATIONAL PKWY STE 1061, LAKE MARY, FL 32746-1412
(407) 323-1234
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO4146
FL
213EP0504X
Public Medicine Podiatrist
PO4146
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
PO4146
FL
213ES0000X
Sports Medicine Podiatrist
PO4146
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
213E00000X
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO4146
FL
213ES0131X
Foot Surgery Podiatrist
PO4146
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114134200
—
FL
01
—
15165159
CAQH ID
—
01
—
PRLE4
BCBS
FL
Enumeration date
04/03/2018
Last updated
10/27/2023
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