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Organization
GERIATRIC PROVIDERS LLC
Active
Organization
GERIATRIC PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DINAKAR KOTIYAN NP (ADMINISTRATOR)
(561) 557-4728
Entity
Organization
Contact information
Practice address
3838 NORTHLAKE BLVD, PALM BEACH GARDENS, FL 33403-1535
(561) 557-4728
(855) 344-0366
Mailing address
3838 NORTHLAKE BLVD, PALM BEACH GARDENS, FL 33403-1535
(561) 557-4728
(855) 344-0366
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L13000153711
NONE
FL
Enumeration date
11/11/2013
Last updated
11/11/2013
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