Individual
DR. JERRY N SHUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
790 CONCOURSE PKWY S, SUITE 200, MAITLAND, FL 32751
(407) 767-6411
(407) 767-8160
Mailing address
1033 DR MARTIN LUTHER KING JR ST N, SUITE 108, ST PETERSBURG, FL 33701-1547
(727) 456-3288
(727) 456-3289
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME35948
FL
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
ME35948
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067967400
—
FL
Enumeration date
04/19/2007
Last updated
12/05/2023
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