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 1:1903 S CONGRESS AVE STE 455
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6559
Mailing Address - Country:US
Mailing Address - Phone:561-336-4790
Mailing Address - Fax:949-561-5955
Practice Address - Street 1:809 N DIXIE HWY STE 200
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3356
Practice Address - Country:US
Practice Address - Phone:561-336-4790
Practice Address - Fax:949-561-5955
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1068662084P0800X, 2084P0804X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X7250OtherBLUE CROSS BLUE SHIELD
TX8X7250OtherBLUE CROSS BLUE SHIELD