Provider Demographics
NPI:1023033040
Name:JOSHI, SHAILESH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAILESH
Middle Name:
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 US HIGHWAY 27 N STE D
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-7840
Mailing Address - Country:US
Mailing Address - Phone:863-385-8505
Mailing Address - Fax:863-658-6848
Practice Address - Street 1:6801 US HIGHWAY 27 N STE D
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-7840
Practice Address - Country:US
Practice Address - Phone:863-385-8505
Practice Address - Fax:863-658-6848
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64867207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376131200Medicaid
FL25914OtherBCBS
110194611OtherRAILROAD MEDICARE
110194611OtherRAILROAD MEDICARE
FL25914OtherBCBS
FL376131200Medicaid