Provider Demographics
NPI:1366465783
Name:SIKARIA, KRISHNA M (MD)
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:M
Last Name:SIKARIA
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 1:238 FIDDLERS POINT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6133
Mailing Address - Country:US
Mailing Address - Phone:904-825-4333
Mailing Address - Fax:
Practice Address - Street 1:301 HEALTH PARK BLVD
Practice Address - Street 2:STE # 329
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5793
Practice Address - Country:US
Practice Address - Phone:904-825-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064435207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375418900Medicaid
FL25436OtherFL BLUE CROSS BLUE SHIELD
FL060052505OtherRAILROAD MEDICARE
FL25436OtherFL BLUE CROSS BLUE SHIELD
FL060052505OtherRAILROAD MEDICARE