Provider Demographics
NPI:1811161581
Name:ASOKAN, KANNYA PARAMESHWARI (MD)
Entity type:Individual
Prefix:DR
First Name:KANNYA
Middle Name:PARAMESHWARI
Last Name:ASOKAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KANNYA
Other - Middle Name:PARAMESHWARI
Other - Last Name:BOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17512 DONA MICHELLE DR STE 5
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3265
Mailing Address - Country:US
Mailing Address - Phone:813-586-7600
Mailing Address - Fax:813-605-6062
Practice Address - Street 1:17512 DONA MICHELLE DR STE 5
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3265
Practice Address - Country:US
Practice Address - Phone:813-586-7600
Practice Address - Fax:813-605-6062
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-33498207Q00000X
FLME129892207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021951100Medicaid