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General NPI Number Information
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NPI Number | 1518837715
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Entity Type | Organization
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Legal Business Name | MEDIKWA, INC
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 3920 BEE RIDGE RD STE A
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City | SARASOTA
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State | FL
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Zip | 34233-1207
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Country | US
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Telephone | 941-921-7744
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Fax | 941-921-7744
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Provider Business Mailing Address
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Address Line | PO BOX 3979
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City | SARASOTA
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State | FL
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Zip | 34230-3979
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Country | US
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Telephone | 941-921-7744
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Fax | 941-388-7051
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | JANICE R WADE
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Credential |
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Telephone | 941-921-7744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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