Individual ProviderSurekha GorantlaNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2240 M St NW, Washington, DC 20037-1415(866) 389-2727PECOS EnrollmentBased on the most recent information from CMS, provider Surekha Gorantla does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:04 AM.Profile DetailsProvider ID1144548660Provider TypeIndividualFull NameGorantla, SurekhaGenderFemaleSole ProprietorNoEnumeration Date5/7/2010Last Updated5/4/2016Contact InformationPractice LocationPractice Address2240 M St NW, Washington, DC 20037-1415Phone(866) 389-2727FaxUnlisted FaxMailing LocationMailing Address12637 Billington Rd, Silver Spring, MD 20904-1506Phone(866) 389-2727FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense1003059District of Columbia