Provider Demographics
NPI:1689801300
Name:MEHTA, SHRITI MASRANI (MD)
Entity Type:Individual
Prefix:
First Name:SHRITI
Middle Name:MASRANI
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHRITI
Other - Middle Name:KIRIT
Other - Last Name:MASRANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1330 BUDINGER AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4137
Mailing Address - Country:US
Mailing Address - Phone:407-891-2940
Mailing Address - Fax:
Practice Address - Street 1:1330 BUDINGER AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4137
Practice Address - Country:US
Practice Address - Phone:407-891-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-20
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009013690207R00000X
NC2016-00566207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology