Healthcare Provider Details

I. General information

NPI: 1679401541
Provider Name (Legal Business Name): MEDIKA PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4944 SW BERMUDA WAY
PALM CITY FL
34990-1261
US

IV. Provider business mailing address

4944 SW BERMUDA WAY
PALM CITY FL
34990-1261
US

V. Phone/Fax

Practice location:
  • Phone: 772-800-5587
  • Fax:
Mailing address:
  • Phone: 772-800-5587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOADNER ISMA
Title or Position: CEO
Credential: MD
Phone: 561-729-3023