Provider Demographics
NPI:1720098544
Name:SHASTRI, MILIND (MD)
Entity type:Individual
Prefix:
First Name:MILIND
Middle Name:
Last Name:SHASTRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:14690 SPRING HILL DR STE 305
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:2315 HIGHWAY 41 N
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-2454
Practice Address - Country:US
Practice Address - Phone:352-480-0560
Practice Address - Fax:352-480-0565
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78967207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1063478OtherCARE PLUS-PASADENA AVE S
FL1842078OtherUNITED HEALTH CARE
FL266778OtherAVMED
FL02898951OtherNEW YORK MEDICAID
FL1063479OtherCAREPLUS-WEST BAY
FLP00192195OtherRAILROAD MEDICARE
FL11074601OtherCITRUS-49TH STREET
FL275294800OtherMEDIPASS
FL49263OtherBLUE CROSS BLUE SHEILD OF FLORIDA
FLUSE TAX IDOtherBEECH STREET
FL11074603OtherCITRUS-WEST BAY
FL11074602OtherCITRUS-PASADENA AVE S
FL201266825OtherAVALON
FL275294800Medicaid
FL3626316OtherAETNA-HMO
FL40185826OtherCOLORADO MEDICAID
FL5450579OtherAETNA
FL2310456OtherCIGNA
FL$$$$$$$$$OtherTRICARE
FL01109877OtherAMERIGROUP-MEDICARE
FL1022785OtherCAREPLUS-49TH STREET
FLP02958OtherFREEDOM HEALTH
FL11074601OtherCITRUS-49TH STREET
FL11074602OtherCITRUS-PASADENA AVE S