Individual
DR. SHEVANTI MANJULA JEGASOTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
135 SAN LORENZO AVE STE 870, CORAL GABLES, FL 33146-1879
(305) 569-0067
(305) 569-0110
Mailing address
135 SAN LORENZO AVE STE 870, CORAL GABLES, FL 33146-1879
(305) 569-0067
(305) 569-0110
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0071046
FL
207N00000X
Dermatology Physician
ME0071046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2292815
AETNA
FL
05
—
255140300
—
FL
Enumeration date
07/18/2006
Last updated
02/12/2013
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