Basic Information
| Provider Information | |||||||||
| NPI: | 1063426625 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHERIDAN | ||||||||
| FirstName: | INDRANI | ||||||||
| MiddleName: | ANASTASIA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6318 ROMANIA DR | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995166015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166473770 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1329 SW 16TH ST | ||||||||
| Address2: | 100186 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522655911 | ||||||||
| FaxNumber: | 3522655606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 12/29/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | ME77738 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.