MEDICARE: SRILAKSHMI ANAMANDALA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	232144	MA
2	207Q00000X	Family Medicine Physician	ME118389	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14TQ	OTHER	FL	BCBS
2	9452280	OTHER	FL	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093932576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRILAKSHMI ANAMANDALA MD

Provider Business Mailing Address
First Line	:	PO BOX 25487
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34277-2487
Country	:	US
Telephone Number	:	941-202-5342
Fax Number	:	855-253-4836

Provider Business Practice Location Address
First Line	:	8620 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-3049
Country	:	US
Telephone Number	:	941-966-4949
Fax Number	:	941-966-2489

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	03/24/2016

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