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1730388067
SHOBA THEIVANAYAGAM
KISSIMMEE, FL
NPI
1730388067
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207RG0100X Internal Medicine, Gastroenterology
(Licence: FL ME148442)
Enumeration Date
2007-07-17
Last Update Date
2021-10-27
Business Address
Dr. SHOBA THEIVANAYAGAM M.D
812 W OAK ST
KISSIMMEE, FL 34741-6625
Phone number: 407-201-3686
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Mailing Address
Dr. SHOBA THEIVANAYAGAM M.D
PO BOX 782009
ORLANDO, FL 32878-2009
Phone number: 407-201-3686
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