# SKYE CONSULTORIO MEDICO LLC

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

## Provider details

- **NPI number:** 1821835893
- **Authorized official:** MR. ROBERT TATE (CEO)
- **Authorized official phone:** (334) 233-8283

## Contact information

- **Practice address:** 3813 ROSS CLARK CIR STE 300, DOTHAN, AL 36303-2881
- **Practice address phone:** (334) 479-0505
- **Mailing address:** 1107 N EASTERN BLVD, MONTGOMERY, AL 36117-2290
- **Mailing address phone:** (334) 647-1444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/09/2024
- **Last updated:** 07/09/2024