Provider Demographics
NPI:1851803589
Name:SKRK LLC
Entity Type:Organization
Organization Name:SKRK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHRIRAM
Authorized Official - Middle Name:SHRIDHAR
Authorized Official - Last Name:MARATHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-347-3434
Mailing Address - Street 1:6445 SW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2954
Mailing Address - Country:US
Mailing Address - Phone:904-347-3434
Mailing Address - Fax:
Practice Address - Street 1:6445 SW 27TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:904-347-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty