Individual
KANAKLAKSHMI MASODKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 ARDISIA LN, SAINT JOHNS, FL 32259-3881
(904) 376-3800
(904) 390-7458
Mailing address
PO BOX 748519, ATLANTA, GA 30374-8519
(904) 376-3800
(904) 376-3998
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
40562
SC
2084P0800X
Psychiatry Physician
Primary
ME164601
FL
Other
Enumeration date
06/05/2013
Last updated
09/11/2025
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