Provider Demographics
NPI:1073558433
Name:SARKAR, RINA (MD)
Entity Type:Individual
Prefix:
First Name:RINA
Middle Name:
Last Name:SARKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12555 ORANGE DR
Mailing Address - Street 2:SUITE# 105
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:630 N KIMBALL AVE
Practice Address - Street 2:SUITE# 110
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6645
Practice Address - Country:US
Practice Address - Phone:817-488-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2015-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00880988Medicaid
NYB58786Medicare UPIN
NY220AN1Medicare PIN
NY06530GMedicare PIN