Provider Demographics
NPI:1356225023
Name:SEENANAN, GAYATRI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:GAYATRI
Middle Name:
Last Name:SEENANAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:GAYATRI
Other - Middle Name:
Other - Last Name:SEENANAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:4603 RAMSHEAD DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-9347
Mailing Address - Country:US
Mailing Address - Phone:347-881-5473
Mailing Address - Fax:
Practice Address - Street 1:4603 RAMSHEAD DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-9347
Practice Address - Country:US
Practice Address - Phone:347-881-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11041225363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology