Provider Demographics
NPI:1942296264
Name:SKARDA, JANET S (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:S
Last Name:SKARDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 LAKELAND HILLS BLVD
Mailing Address - Street 2:ATTN MEDICAL STAFF OFFICE
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 PABLO ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-3818
Practice Address - Country:US
Practice Address - Phone:863-687-1259
Practice Address - Fax:863-284-1786
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82421208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI06325Medicare UPIN
FLDA5786OtherRAILROAD MEDICARE GROUP NUMBER
FLAB703YMedicare PIN
FL1497748743OtherGROUP NPI NUMBER / LRHSI
FL44134OtherBCBS OF FLORIDA
FL268958800Medicaid