Doc Aesthetics.LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

DOC AESTHETICS.LLC

Practice address

2215 Nebraska Ave
Ste 2B
Fort Pierce, FL 34950-4867

Phone

(772) 302-3767

NPI assigned

Oct 23, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chintan Shah, MD

Title

Provider

Phone

(772) 302-3767

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1275354128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NEBRASKA AVE",
            "address_2": "STE 2B",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "34950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 NEBRASKA AVE",
            "address_2": "STE 2B",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504867",
            "telephone_number": "772-302-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOC AESTHETICS.LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "CHINTAN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "772-302-3767",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006739300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.