Provider Demographics
NPI:1063426625
Name:SHERIDAN, INDRANI ANASTASIA (MD)
Entity type:Individual
Prefix:
First Name:INDRANI
Middle Name:ANASTASIA
Last Name:SHERIDAN
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 1:6318 ROMANIA DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-6015
Mailing Address - Country:US
Mailing Address - Phone:516-647-3770
Mailing Address - Fax:
Practice Address - Street 1:1329 SW 16TH ST
Practice Address - Street 2:100186
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610
Practice Address - Country:US
Practice Address - Phone:352-265-5911
Practice Address - Fax:352-265-5606
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77738207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine