Jegasothy, Shevanti Manjula

Jegasothy, Shevanti Manjula is an individual health care provider with primary practice located at 135 San Lorenzo Ave Ste 870 , Coral Gables FL 33146-1879. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Other Service Providers / Specialist is her primary health care specialty. Jegasothy, Shevanti Manjula can be contacted via phone (305) 569-0067.

Contact Information

Primary practice address
135 San Lorenzo Ave Ste 870 Coral Gables FL 33146-1879
Fax: (305) 569-0110
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME0071046 Florida
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME0071046 Florida

Profile Details

NPI number 1639197288
LBN Legal business name Jegasothy, Shevanti Manjula
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Feb 12th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639197288 NPPES
Florida MEDICAID 255140300
Florida Other 2292815

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