ANANDAVALLI KRISHNAMOORTHY (NPI# 1205821287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205821287 |
| Entity Type | Individual |
| Full Name | ANANDAVALLI KRISHNAMOORTHY |
| Credential | MD |
| Practice Address |
936 E Parker St Lakeland FL 33801-1968 |
| Mailing Address |
950 County Road 17a W Avon Park FL 33825-2164 |
| Practice Telephone | 8634138600 |
| Practice Fax Number | 8634138650 |
| Mailing Telephone | 8634523060 |
| Mailing Fax Number | 8634523069 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2008-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | ME79252 | FL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | ME79252 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS OF FLORIDA | 05096 | 01 |
| FL | 261259300 | 05 |
| Street Address |
936 E PARKER ST |
| City | LAKELAND |
| State | FL |
| Zip Code | 33801-1968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538318035 | Suzanne M Victorine | Nurse Practitioner | 936 E Parker St, Lakeland, FL 33801-1968 | 2008-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473802 | Camryn Nichole White | Assistant Behavior Analyst | 301 South Florida Ave, Lakeland, FL 33801 | 2020-09-30 |
| 1932719242 | Jimia Watkins | Home Health Aide | 2410 Lakeview St, Lakeland, FL 33801 | 2020-08-03 |
| 1396366886 | Erin Zimmer | Health Educator | 491 Lake Parker Ave, Lakeland, FL 33801 | 2020-05-06 |
| 1013473206 | Madelyn Claire Burley | Occupational Therapist | 1215 East Orange Street, Lakeland, FL 33801 | 2019-02-13 |
| 1992260319 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 1617 Us Highway 98 S, Lakeland, FL 33801 | 2019-02-11 |
| 1669908836 | Integrative Physical Medicine of Lakeland LLC | Specialist | 1205 East Magnolia St, Suite 105, Lakeland, FL 33801 | 2017-05-10 |
| 1689111502 | Daryl Dowding | Counselor | 390 Alcaia Rd., Lakeland, FL 33801 | 2017-01-30 |
| 1023481926 | Joseph D'alessandro | Specialist/Technologist | 111 Lake Hollingsworth Dr Box 4334, Lakeland, FL 33801 | 2015-11-02 |
| 1588030894 | Donna Lee Buckner | Specialist/Technologist | 111 Mosswood Road, Lakeland, FL 33801 | 2015-08-20 |
| 1144635780 | Donna Paige Mccraney | Nurse Practitioner | 111 Lake Hollingsworth Drive, Florida Southern College Student Health Center, Lakeland, FL 33801 | 2014-06-23 |
| Find all providers in zip 33801 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121909 | Amanda Millican | Family Medicine | 605 Laura Rd, Lakeland, FL 33815-3220 | 2020-10-14 |
| 1093320848 | Katrena Borders Flowers | Family Medicine | 2629 Highlands Creek Way, Lakeland, FL 33813-6301 | 2020-09-09 |
| 1578177523 | Robinson Family Clinic Inc | Family Medicine | 4406 S Florida Ave Ste 30, Lakeland, FL 33813-2176 | 2020-09-06 |
| 1306467311 | Christopher James Miller | Family Medicine | 215 S Elm Rd, Lakeland, FL 33801-2310 | 2020-04-30 |
| 1811480387 | Victoria Anne Morin | Family Medicine | 1463 Town Center Dr, Lakeland, FL 33803-7966 | 2018-06-10 |
| 1467890665 | Rachael Veronique Ollivierre-agard | Family Medicine | 170 Fitzgerald Rd Ste 1, Lakeland, FL 33813-2633 | 2013-06-10 |
| 1740587211 | Javier Andres Diago Benjumea | Family Medicine | 3015 Lakeland Highlands Rd, Lakeland, FL 33803-4339 | 2011-02-18 |
| 1891099792 | Sergio B Seoane Md Pa | Family Medicine | 118 Allamanda Sr, Lakeland, FL 33803 | 2011-01-06 |
| 1063673812 | Avantica Gondi | Family Medicine | 1818 Harden Blvd Ste 120, Lakeland, FL 33803-1813 | 2008-06-24 |
| 1942460902 | Michael Curtiss | Family Medicine | 2039 E Edgewood Dr, Suite B, Lakeland, FL 33803-3601 | 2008-06-12 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.