MEDICARE: ANANTHALAKSHMI KRISHNAN M.D.

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	208000000X	Pediatrics Physician	ME57036	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	BLUE CROSS BLUE SHEI	OTHER	FL	BCBS OF FLORIDA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477629525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANANTHALAKSHMI KRISHNAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-343-9888
Fax Number	:	239-468-7937

Provider Business Practice Location Address
First Line	:	414 CAPE CORAL PKWY E STE 103
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-8522
Country	:	US
Telephone Number	:	239-343-9888
Fax Number	:	239-468-7937

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	10/27/2025

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Directions to “ ANANTHALAKSHMI KRISHNAN M.D.” Practice Location

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