Provider Demographics
NPI:1508832361
Name:MADKAIKER, PRITA S (MD)
Entity Type:Individual
Prefix:DR
First Name:PRITA
Middle Name:S
Last Name:MADKAIKER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:P O BOX 24330
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32241-4330
Mailing Address - Country:US
Mailing Address - Phone:904-292-4129
Mailing Address - Fax:904-268-3293
Practice Address - Street 1:3685 CROWN POINT COURT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257
Practice Address - Country:US
Practice Address - Phone:904-292-4129
Practice Address - Fax:904-268-3293
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2011-11-19
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Provider Licenses
StateLicense IDTaxonomies
FLME81136207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI24101Medicare UPIN