Individual
KRISHNAKANTHAN SASANKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-5102
(352) 265-0111
Mailing address
PO BOX 100296, GAINESVILLE, FL 32610-3003
(352) 627-9350
(352) 273-9054
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
193354
NY
208000000X
Pediatrics Physician
Primary
ME161851
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010157703
UNIVERA
NY
01
—
000523039005
BC/BS
NY
05
—
01439409
—
NY
01
—
040426002481
FIDELIS
NY
01
—
1209766
IHA
NY
01
—
143850DL
PREFERRED CARE
NY
Enumeration date
10/20/2005
Last updated
12/28/2023
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