Provider Demographics
NPI:1598652786
Name:SHALSI, ORTENCA (OD)
Entity type:Individual
Prefix:DR
First Name:ORTENCA
Middle Name:
Last Name:SHALSI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 TURNSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-5329
Mailing Address - Country:US
Mailing Address - Phone:727-563-6635
Mailing Address - Fax:
Practice Address - Street 1:27001 US HIGHWAY 19 N STE 2004
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3421
Practice Address - Country:US
Practice Address - Phone:727-669-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6765152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist