MEDICARE: DR. ADAM MICHAEL CLOSE M.D., B.SC.

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
1	207V00000X	Obstetrics & Gynecology Physician	ME137068	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	KK405	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649681602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM MICHAEL CLOSE M.D., B.SC.

Provider Business Mailing Address
First Line	:	3300 S FISKE BLVD
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4306
Country	:	US
Telephone Number	:	321-312-3477
Fax Number	:

Provider Business Practice Location Address
First Line	:	3425 BAYSIDE LAKES BLVD SE STE 110
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-6867
Country	:	US
Telephone Number	:	321-312-3477
Fax Number	:	321-637-1598

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	04/11/2022

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Directions to “ DR. ADAM MICHAEL CLOSE M.D., B.SC.” Practice Location

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