Organization
JERRY N. SHUSTER, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY N SHUSTER MD, MBA (OPHTHALMOLOGIST)
(407) 767-6411
Entity
Organization
Contact information
Practice address
790 CONCOURSE PKWY S, SUITE 200, MAITLAND, FL 32751-6114
(407) 767-6411
Mailing address
3030 LAKE SHORE DR, ORLANDO, FL 32803-1122
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35948
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067967400
—
FL
Enumeration date
10/19/2006
Last updated
01/17/2012
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