Provider Demographics
NPI:1730222134
Name:KRISHNAPRASAD, DEEPIKA (MD)
Entity type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:
Last Name:KRISHNAPRASAD
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 1:1150 NW 14TH ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-2137
Mailing Address - Country:US
Mailing Address - Phone:305-243-6837
Mailing Address - Fax:305-243-8470
Practice Address - Street 1:1150 NW 14TH ST
Practice Address - Street 2:SUITE 407
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2137
Practice Address - Country:US
Practice Address - Phone:305-243-6837
Practice Address - Fax:305-243-8470
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME35473207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0680737-00Medicaid
FL0680737-00Medicaid
FL95815Medicare ID - Type Unspecified