Provider Demographics
NPI:1962064493
Name:CKK MEDICAL LLC
Entity type:Organization
Organization Name:CKK MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAIYED
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-658-5556
Mailing Address - Street 1:6600 SW STATE ROAD 200 # 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-5554
Mailing Address - Country:US
Mailing Address - Phone:352-658-5556
Mailing Address - Fax:352-600-6960
Practice Address - Street 1:6600 SW STATE ROAD 200 # 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-5554
Practice Address - Country:US
Practice Address - Phone:352-658-5556
Practice Address - Fax:352-600-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-04
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty