Provider Demographics
NPI:1205809217
Name:SANKA, SRINIVAS (DO)
Entity type:Individual
Prefix:
First Name:SRINIVAS
Middle Name:
Last Name:SANKA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:730 SE 5TH TERRACE
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-4326
Practice Address - Country:US
Practice Address - Phone:352-699-2040
Practice Address - Fax:352-699-2042
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS8662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264373100Medicaid
FLE7694ZMedicare PIN
H64839Medicare UPIN