Provider Demographics
NPI:1619435179
Name:TRICOUNTY HEALTH LLC
Entity type:Organization
Organization Name:TRICOUNTY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHRIKANTH
Authorized Official - Middle Name:
Authorized Official - Last Name:UPADYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-726-8353
Mailing Address - Street 1:4056 E STATE ROAD 44
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-7486
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4056 E STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-7486
Practice Address - Country:US
Practice Address - Phone:732-335-6516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty