# GERIATRIC PROVIDERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801225875
- **Authorized official:** DINAKAR KOTIYAN NP (ADMINISTRATOR)
- **Authorized official phone:** (561) 557-4728

## Contact information

- **Practice address:** 3838 NORTHLAKE BLVD, PALM BEACH GARDENS, FL 33403-1535
- **Practice address phone:** (561) 557-4728
- **Practice address fax:** (855) 344-0366
- **Mailing address:** 3838 NORTHLAKE BLVD, PALM BEACH GARDENS, FL 33403-1535
- **Mailing address phone:** (561) 557-4728
- **Mailing address fax:** (855) 344-0366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/11/2013
- **Last updated:** 11/11/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | L13000153711 | NONE | FL |