Individual
SUNITA TIKKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1061 MEDICAL CENTER DR STE 205, ORANGE CITY, FL 32763-8226
(386) 917-7610
(386) 917-7615
Mailing address
1061 MEDICAL CENTER DR STE 205, ORANGE CITY, FL 32763-8226
(386) 917-7610
(386) 917-7615
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
25MA07725800
NJ
2084P0800X
Psychiatry Physician
Primary
ME100501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4144007
—
NJ
Enumeration date
10/26/2006
Last updated
10/11/2019
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