Provider Demographics
NPI:1750329330
Name:SHENOY, PARNA (MD)
Entity Type:Individual
Prefix:
First Name:PARNA
Middle Name:
Last Name:SHENOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 MATTHEW DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1702
Mailing Address - Country:US
Mailing Address - Phone:239-278-4733
Mailing Address - Fax:239-278-4730
Practice Address - Street 1:1560 MATTHEW DR
Practice Address - Street 2:SUITE G
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1702
Practice Address - Country:US
Practice Address - Phone:239-278-4733
Practice Address - Fax:239-278-4730
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86175207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H79575Medicare UPIN
P00304634Medicare PIN
FL57663ZMedicare PIN
FL57663Medicare ID - Type Unspecified