Organization
ANANTHALAKSHMI KRISHNAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTY LAUX (MANAGER)
(239) 772-3295
Entity
Organization
Contact information
Practice address
126 DEL PRADO BLVD N, SUITE 101, CAPE CORAL, FL 33909-2713
(239) 772-3295
(239) 772-5084
Mailing address
126 DEL PRADO BLVD N, SUITE 101, CAPE CORAL, FL 33909-2713
(239) 772-3295
(239) 772-5084
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0057036
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053542700
—
FL
Enumeration date
06/20/2014
Last updated
06/20/2014
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