| Pooja Shastri, Psy.d., P.a. | |
|
13430 Parker Commons Blvd Ste 101 Fort Myers FL 33912-1812 | |
| (239) 561-9955 | |
| (239) 561-9779 |
| Full Name | Pooja Shastri, Psy.d., P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 13430 Parker Commons Blvd Ste 101, Fort Myers, Florida |
| Authorized Official Name and Position | Pooja Shastri (PRESIDENT) |
| Authorized Official Contact | 7736772170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pooja Shastri, Psy.d., P.a. 3606 Treasure Cove Cir Naples FL 34114-3983 Ph: () - | Pooja Shastri, Psy.d., P.a. 13430 Parker Commons Blvd Ste 101 Fort Myers FL 33912-1812 Ph: (239) 561-9955 |
| NPI Number | 1891334157 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 01/03/2020 |
| Certification Date | 01/03/2020 |
| Medicare PECOS PAC ID | 4082043534 |
|---|---|
| Medicare Enrollment ID | O20200403000642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891334157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Pooja S Shastri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932656899 PECOS PAC ID: 9638450307 Enrollment ID: I20170111003604 |
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