Provider Demographics
NPI:1033152111
Name:SUBRAMANIAN, KIONA R (MD)
Entity Type:Individual
Prefix:DR
First Name:KIONA
Middle Name:R
Last Name:SUBRAMANIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6228 NW 43RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-8871
Mailing Address - Country:US
Mailing Address - Phone:352-332-6680
Mailing Address - Fax:352-332-6604
Practice Address - Street 1:6228 NW 43RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-8871
Practice Address - Country:US
Practice Address - Phone:352-332-6680
Practice Address - Fax:352-332-6604
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2013-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA306331OtherSOUTHERN HEALTH
VAP00229852OtherPALMETTO GBA
VA4132903OtherMAMSI
VA95535OtherCOMMUNITY HEALTH
VA0895051OtherCIGNA
VA179792OtherANTHEM SVC/HEALTHKEEPERS
VA179792OtherANTHEM SVC/HEALTHKEEPERS
VA0895051OtherCIGNA
VA95535OtherCOMMUNITY HEALTH