Healthcare Provider Details

I. General information

NPI: 1346218492
Provider Name (Legal Business Name): MADHUKAR SHRINATH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SW 20TH PL.
OCALA FL
34471
US

IV. Provider business mailing address

1900 SW 20TH PL.
OCALA FL
34471-7870
US

V. Phone/Fax

Practice location:
  • Phone: 352-840-5437
  • Fax: 352-237-1094
Mailing address:
  • Phone: 352-840-5437
  • Fax: 352-237-1094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME76333
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: