Healthcare Provider Details

I. General information

NPI: 1588629232
Provider Name (Legal Business Name): SATYEN P. MADKAIKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3685 CROWN POINT CT SUITE 3
JACKSONVILLE FL
32257
US

IV. Provider business mailing address

PO BOX 24330
JACKSONVILLE FL
32241-4330
US

V. Phone/Fax

Practice location:
  • Phone: 904-880-8840
  • Fax: 904-880-1994
Mailing address:
  • Phone: 904-880-8840
  • Fax: 904-880-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME83139
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: