Provider Demographics
NPI:1811344518
Name:ASHOKA HEALTHCARE, LLC
Entity type:Organization
Organization Name:ASHOKA HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIDMORE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN MPH
Authorized Official - Phone:352-431-1300
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34492-0028
Mailing Address - Country:US
Mailing Address - Phone:352-431-1300
Mailing Address - Fax:
Practice Address - Street 1:17820 SE 109TH AVE
Practice Address - Street 2:STE 104
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8968
Practice Address - Country:US
Practice Address - Phone:352-431-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHOKA HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty