Pelletier, Jesse Shane

Pelletier, Jesse Shane is an sole proprietor health care provider with primary practice located at 1400 Ne Miami Gardens Dr Suite 203, North Miami Beach FL 33179-4845. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Pelletier, Jesse Shane can be contacted via phone (305) 940-1500.

Contact Information

Primary practice address
1400 Ne Miami Gardens Dr Suite 203 North Miami Beach FL 33179-4845
Phone: (305) 940-1500
Fax: (305) 940-1501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME99313 Florida

Profile Details

NPI number 1952440372
LBN Legal business name Pelletier, Jesse Shane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 5th, 2007
Last updated Feb 2nd, 2012 - about 12 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 1952440372 NPPES
Florida MEDICAID 279056400

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