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NPI Code Detail

MEDICARE: DR. RISHI ASHOK MODH M.D.

MEDICARE: DR. RISHI ASHOK MODH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianME127972FL

General Provider Information

NPI Number : 1033401997
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RISHI ASHOK MODH M.D.
Provider Business Mailing Address
First Line : 12109 COUNTY ROAD 103
Second Line :
City : OXFORD
State : FL
Zip : 34484-2951
Country : US
Telephone Number : 352-205-8981
Fax Number : 352-391-6498
Provider Business Practice Location Address
First Line : 5747 38TH AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33710-1925
Country : US
Telephone Number : 727-381-8667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2011
Last Update Date : 02/09/2021

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