Provider Demographics
NPI:1811294481
Name:INFECTIOUS DISEASES CONSULTANTS MADHURI SANKURATRI MD LLC
Entity type:Organization
Organization Name:INFECTIOUS DISEASES CONSULTANTS MADHURI SANKURATRI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:MR
Authorized Official - First Name:VENKATESWARA
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:SANKURATRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-213-7028
Mailing Address - Street 1:10144 SW 98TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-6022
Mailing Address - Country:US
Mailing Address - Phone:352-213-7028
Mailing Address - Fax:
Practice Address - Street 1:3140 NW MEDICAL CENTER LN
Practice Address - Street 2:STE 120
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4717
Practice Address - Country:US
Practice Address - Phone:352-213-6722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL93568207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty