Provider Demographics
NPI:1467410167
Name:INTERNAL MEDICINE AND GERIATRICS ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE AND GERIATRICS ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARUNAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:SKIRK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-757-7541
Mailing Address - Street 1:240 N WICKHAM RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-8662
Mailing Address - Country:US
Mailing Address - Phone:321-757-7541
Mailing Address - Fax:321-757-7343
Practice Address - Street 1:240 N WICKHAM RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8662
Practice Address - Country:US
Practice Address - Phone:321-757-7541
Practice Address - Fax:321-757-7343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0087447207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1367AMedicare ID - Type UnspecifiedMEDICARE
FLH94625Medicare UPIN