Provider Demographics
NPI:1134217987
Name:ID CONSULTANTS INC
Entity type:Organization
Organization Name:ID CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SRINATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-735-7531
Mailing Address - Street 1:2300 S CONGRESS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-7400
Mailing Address - Country:US
Mailing Address - Phone:561-735-7531
Mailing Address - Fax:561-742-8250
Practice Address - Street 1:2300 S CONGRESS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7400
Practice Address - Country:US
Practice Address - Phone:561-735-7531
Practice Address - Fax:561-742-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00017567207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114113900Medicaid
FL123158400Medicaid
FL119744400Medicaid
FL119531200Medicaid
FL252633600Medicaid