MEDICARE: INFECTIOUS DISEASES CONSULTANTS MADHURI SANKURATRI MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	93568	FL

General Provider Information

NPI Number	:	1811294481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFECTIOUS DISEASES CONSULTANTS MADHURI SANKURATRI MD LLC

Provider Business Mailing Address
First Line	:	10144 SW 98TH TER
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-6022
Country	:	US
Telephone Number	:	352-213-7028
Fax Number	:

Provider Business Practice Location Address
First Line	:	3140 NW MEDICAL CENTER LN
Second Line	:	STE 120
City	:	LAKE CITY
State	:	FL
Zip	:	32055-4717
Country	:	US
Telephone Number	:	352-213-6722
Fax Number	:

Authorized Official
Title or Position	:	MGRM
Name	:	MR. VENKATESWARA RAO SANKURATRI
Credential	:
Telephone Number	:	352-213-7028

Provider Enumeration Date	:	02/17/2011
Last Update Date	:	03/21/2011

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