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General NPI Number Information
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NPI Number | 1669836847
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Entity Type | Organization
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Legal Business Name | AKRO GASTRO, LLC
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 201 SW 16TH ST
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City | OKEECHOBEE
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State | FL
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Zip | 34974-6117
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Country | US
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Telephone | 863-824-3347
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Fax | 863-824-3472
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Provider Business Mailing Address
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Address Line | 201 SW 16TH ST
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City | OKEECHOBEE
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State | FL
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Zip | 34974-6117
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Country | US
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Telephone | 863-824-3347
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Fax | 863-824-3472
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Authorized Official
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Title or Position | OWNER
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Name | DR. VIKRAM TARUGU
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Credential | M.D.
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Telephone | 863-824-3447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME10611
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License Number State | FL
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