Provider Demographics
NPI:1215674114
Name:GERIATRIC INSTITUTE CORP
Entity type:Organization
Organization Name:GERIATRIC INSTITUTE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCHATELLIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-810-3016
Mailing Address - Street 1:9613 SW 53RD CIR
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-4057
Mailing Address - Country:US
Mailing Address - Phone:214-810-3016
Mailing Address - Fax:
Practice Address - Street 1:5850 SE 5TH ST UNIT 101
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-1200
Practice Address - Country:US
Practice Address - Phone:214-810-3016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARTIAL DUCHATELLIER PHD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty