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General NPI Number Information
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NPI Number | 1811294481
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASES CONSULTANTS MADHURI SANKURATRI MD LLC
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 3140 NW MEDICAL CENTER LN STE 120
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City | LAKE CITY
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State | FL
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Zip | 32055-4717
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Country | US
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Telephone | 352-213-6722
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Fax |
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Provider Business Mailing Address
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Address Line | 10144 SW 98TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32608-6022
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Country | US
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Telephone | 352-213-7028
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Fax |
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Authorized Official
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Title or Position | MGRM
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Name | MR. VENKATESWARA RAO SANKURATRI
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Credential |
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Telephone | 352-213-7028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 93568
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License Number State | FL
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