Organization
FLORIDA EYE SPECIALISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJESH SHETTY M. D. (OWNER)
(904) 382-1477
Entity
Organization
Contact information
Practice address
11512 LAKE MEAD AVE, SUITE 534, JACKSONVILLE, FL 32256-9680
(904) 382-1477
Mailing address
1301 1ST ST S, SUITE 707, JACKSONVILLE, FL 32250-6443
(904) 382-1477
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME84552
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28020
BCBSFL
FL
01
—
28020Z
MEDICARE
FL
Enumeration date
03/16/2009
Last updated
06/11/2014
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