Provider Demographics
NPI:1891956264
Name:PRAMOD, SHEENA (MD)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:PRAMOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEENA
Other - Middle Name:
Other - Last Name:SURINDRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 100224
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0224
Mailing Address - Country:US
Mailing Address - Phone:352-273-9180
Mailing Address - Fax:352-392-5465
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190010207R00000X
WV26090207R00000X, 207RN0300X
FLME157148207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810029851Medicaid