Basic Information
Provider Information
NPI: 1386676005
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KULKARNI
FirstName: VIDYA
MiddleName: PRASAD
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SAKHALKAR
OtherFirstName: VIDYA
OtherMiddleName: SADASHIV
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 1601 SW ARCHER RD
Address2: NF/SG VAHS (11Q/C&P)
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber:  
Practice Location
Address1: 1601 SW ARCHER ROAD
Address2: NF/SG VAHS (11Q/C&P)
City: GAINESVILLE
State: FL
PostalCode: 326081197
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/06/2006
LastUpdateDate: 04/24/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XME94090FLY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


Home