Provider Demographics
NPI:1508856576
Name:ASOKAN, SREENIVASAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SREENIVASAN
Middle Name:
Last Name:ASOKAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SREENIVASA
Other - Middle Name:
Other - Last Name:ASOKAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 692529
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-2529
Mailing Address - Country:US
Mailing Address - Phone:407-876-1604
Mailing Address - Fax:407-876-1604
Practice Address - Street 1:715 OAK COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4213
Practice Address - Country:US
Practice Address - Phone:407-931-2816
Practice Address - Fax:407-931-3485
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0055477207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL038946300Medicaid
FLE75823Medicare UPIN
FL09156XMedicare ID - Type Unspecified