Provider Demographics
NPI:1750490991
Name:ANANDAN, SHARADAMANI (MD)
Entity Type:Individual
Prefix:
First Name:SHARADAMANI
Middle Name:
Last Name:ANANDAN
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 1:4631 N CONGRESS AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3209
Mailing Address - Country:US
Mailing Address - Phone:561-803-8219
Mailing Address - Fax:561-803-8220
Practice Address - Street 1:4631 N CONGRESS AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3209
Practice Address - Country:US
Practice Address - Phone:561-803-8219
Practice Address - Fax:561-803-8220
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1068662084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X7250OtherBLUE CROSS BLUE SHIELD
TX8X7250OtherBLUE CROSS BLUE SHIELD