Provider Demographics
NPI:1154389849
Name:SKIRK, SARUNAS S (MD)
Entity type:Individual
Prefix:DR
First Name:SARUNAS
Middle Name:S
Last Name:SKIRK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N WICKHAM RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-8662
Mailing Address - Country:US
Mailing Address - Phone:321-757-7541
Mailing Address - Fax:321-757-7343
Practice Address - Street 1:240 N WICKHAM RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8662
Practice Address - Country:US
Practice Address - Phone:321-757-7541
Practice Address - Fax:321-757-7343
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0087447207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267681800Medicaid
FL267681800Medicaid
FLU1367AMedicare ID - Type UnspecifiedMEDICARE