Individual
SHAMINI GANESHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
801 E 6TH ST STE 307, PANAMA CITY, FL 32401-3663
(850) 804-3823
(850) 608-6423
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6063
(904) 539-4091
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME172396
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
T0307
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1X0794
MEDICARE PTAN
TX
Enumeration date
04/02/2014
Last updated
04/01/2026
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