Provider Demographics
NPI:1679886709
Name:BALAKRISHNAN, KESHAWADHANA (MD,)
Entity Type:Individual
Prefix:DR
First Name:KESHAWADHANA
Middle Name:
Last Name:BALAKRISHNAN
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 S DADELAND BLVD
Mailing Address - Street 2:200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2866
Mailing Address - Country:US
Mailing Address - Phone:305-468-4185
Mailing Address - Fax:305-675-3378
Practice Address - Street 1:4700 SHERIDAN STREET
Practice Address - Street 2:M
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3420
Practice Address - Country:US
Practice Address - Phone:305-468-4185
Practice Address - Fax:305-675-3378
Is Sole Proprietor?:No
Enumeration Date:2010-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1336612080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology