Organization Active NPI

Ananthalakshmi Krishnan

  • Pediatrics Physician
  • Cape Coral, FL
National Provider Identifier
1871907550
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0057036 Issued in FL
Legal business name
ANANTHALAKSHMI KRISHNAN
Practice address
126 Del Prado Blvd N
Suite 101
Cape Coral, FL 33909-2713
Phone
(239) 772-3295
Fax
(239) 772-5084
NPI assigned
Jun 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Authorized official

Name
Patty Laux
Title
Manager
Phone
(239) 772-3295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME0057036 FL Primary

Addresses

Primary practice location

126 Del Prado Blvd N
Suite 101
Cape Coral, FL 33909-2713

Mailing address

126 Del Prado Blvd N
Suite 101
Cape Coral, FL 33909-2713
Phone (239) 772-3295

Other identifiers 1

IdentifierTypeStateIssuer
053542700MedicaidFL

National Provider Directory

National Provider Directory

Locations

126 Del Prado Blvd N
Ste 101
Cape Coral, FL 33909
Phone (239) 772-3295

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1871907550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 DEL PRADO BLVD N",
            "address_2": "SUITE 101",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092713",
            "telephone_number": "239-772-3295",
            "fax_number": "239-772-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 DEL PRADO BLVD N",
            "address_2": "SUITE 101",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092713",
            "telephone_number": "239-772-3295",
            "fax_number": "239-772-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANANTHALAKSHMI KRISHNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "LAUX",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-772-3295"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0057036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053542700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.