Provider Demographics
NPI:1215413232
Name:MADHAVI CHARY LLC
Entity Type:Organization
Organization Name:MADHAVI CHARY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADHAVI
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-501-7053
Mailing Address - Street 1:315 SANDHURST DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-2159
Mailing Address - Country:US
Mailing Address - Phone:321-501-7053
Mailing Address - Fax:206-339-2959
Practice Address - Street 1:315 SANDHURST DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2159
Practice Address - Country:US
Practice Address - Phone:321-501-7053
Practice Address - Fax:206-339-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99819207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty