Provider Demographics
NPI:1346218492
Name:SHRINATH, MADHUKAR (MD)
Entity Type:Individual
Prefix:MR
First Name:MADHUKAR
Middle Name:
Last Name:SHRINATH
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 1:1900 SW 20TH PL.
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7870
Mailing Address - Country:US
Mailing Address - Phone:352-840-5437
Mailing Address - Fax:352-237-1094
Practice Address - Street 1:1900 SW 20TH PL.
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-840-5437
Practice Address - Fax:352-237-1094
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76333208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254422900Medicaid
FLD20879Medicare UPIN