Provider Demographics
NPI:1093769549
Name:SANKOORIKAL, ANTONY G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONY
Middle Name:G
Last Name:SANKOORIKAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 STATE ROAD 580
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3167
Mailing Address - Country:US
Mailing Address - Phone:727-797-7410
Mailing Address - Fax:727-797-7411
Practice Address - Street 1:2655 STATE ROAD 580
Practice Address - Street 2:SUITE 201
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3167
Practice Address - Country:US
Practice Address - Phone:727-797-7410
Practice Address - Fax:727-797-7411
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062422174400000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00030228OtherRR MEDICARE
FL25145OtherBCBS
FL375377800Medicaid
FL375377800Medicaid
FLF15040Medicare UPIN