Healthcare Provider Details

I. General information

NPI: 1669836847
Provider Name (Legal Business Name): AKRO GASTRO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SW 16TH ST
OKEECHOBEE FL
34974-6117
US

IV. Provider business mailing address

201 SW 16TH ST
OKEECHOBEE FL
34974-6117
US

V. Phone/Fax

Practice location:
  • Phone: 863-824-3347
  • Fax: 863-824-3472
Mailing address:
  • Phone: 863-824-3347
  • Fax: 863-824-3472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME10611
License Number StateFL

VIII. Authorized Official

Name: DR. VIKRAM TARUGU
Title or Position: OWNER
Credential: M.D.
Phone: 863-824-3447