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General NPI Number Information
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NPI Number | 1538709993
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Entity Type | Organization
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Legal Business Name | FIRST CLASS MEDICINE LLC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 03/29/2020
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Provider Practice Location Address
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Address Line | 4699 FOX VIEW PL
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City | LAKE WORTH
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State | FL
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Zip | 33467-3540
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Country | US
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Telephone | 561-767-6897
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Fax |
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Provider Business Mailing Address
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Address Line | 4699 FOX VIEW PL
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City | LAKE WORTH
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State | FL
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Zip | 33467-3540
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAMPRASAD GOPALAN
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Credential | MD
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Telephone | 561-767-6897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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