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Individual

SHOBA SRIKANTAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1033 DR MARTIN LUTHER KING JR ST N, SUITE 108, ST PETERSBURG, FL 33701-1547
(727) 456-4250
(727) 346-1044
Mailing address
1033 DR MARTIN LUTHER KING JR ST N, SUITE 108, ST PETERSBURG, FL 33701-1547
(727) 456-4250
(727) 346-1044

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME90295
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269933800
FL
01
43152X
MEDICARE PTAN
FL
Enumeration date
08/25/2006
Last updated
02/03/2010
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