Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shoba Theivanayagam, MD

Individual provider Gastroenterology Physician · NPI 1730388067

Dr. Shoba Theivanayagam, MD is a Gastroenterology in Kissimmee, Florida. Qualified in 2003, 23 years ago. Practices with Gastroenterology Institute of Orlando LLC, a 5-clinician group. Licensed in Florida.

Years since qualifying
23
Licensed in
FL
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

812 W Oak St
Kissimmee, FL 34741-6625
Phone: (407) 201-3686
Fax: (407) 201-3739
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence ME148442 (FL)

Record details

NPI number1730388067
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 17, 2007
Last updated in NPPESOctober 27, 2021
Certification dateOctober 8, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Gastroenterology Institute Of Orlando Llc — 5 clinicians
Accepts Medicare assignment Not indicated

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