Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ME0087447 | FL |
NPI | 1154389849 |
---|---|
Provider Name | Dr. Sarunas S. Skirk |
First Address | Melbourne, FL 32935-8662 |
Second Address | Melbourne, FL 32935-8662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 20/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
267681800 | (05) | FL |
H94625 | (02) | FL |