Individual
DEEPAK TIKKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2808 ENTERPRISE RD, SUITE 104, DEBARY, FL 32713-2753
(386) 624-6900
(386) 624-6993
Mailing address
2808 ENTERPRISE RD, SUITE 104, DEBARY, FL 32713-2753
(386) 624-6900
(386) 624-6993
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME96609
FL
2084N0400X
Neurology Physician
Primary
ME96609
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002197200
—
FL
Enumeration date
11/17/2006
Last updated
04/08/2016
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