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General NPI Number Information
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NPI Number | 1548157597
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Entity Type | Individual
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Provider Name | KRISHA ANIL SHRIMANKAR
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 616 ROBIN RD
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City | LAKELAND
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State | FL
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Zip | 33803-4841
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Country | US
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Telephone | 863-277-6891
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Fax |
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Provider Business Mailing Address
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Address Line | 2681 ROOSEVELT BLVD APT 2309
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City | CLEARWATER
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State | FL
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Zip | 33760-2968
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Country | US
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Telephone | 815-603-6776
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN30421
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License Number State | FL
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