Provider Demographics
NPI:1659193753
Name:MDSK SERVICES CORP
Entity type:Organization
Organization Name:MDSK SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJA
Authorized Official - Middle Name:MOTI
Authorized Official - Last Name:GIDWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-519-5873
Mailing Address - Street 1:1840 W 49TH ST STE 716
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2973
Mailing Address - Country:US
Mailing Address - Phone:650-519-5873
Mailing Address - Fax:
Practice Address - Street 1:1840 W 49TH ST STE 716
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2973
Practice Address - Country:US
Practice Address - Phone:650-519-5873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center