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General NPI Number Information
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NPI Number | 1801312525
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Entity Type | Organization
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Legal Business Name | MODERN MEDICAL CARE,INC
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 08/15/2017
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Provider Practice Location Address
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Address Line | 2415 UNIVERSITY PKWY STE 216
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City | SARASOTA
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State | FL
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Zip | 34243-2809
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Country | US
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Telephone | 941-359-8420
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 BAYOU SOUND
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City | LONGBOAT KEY
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State | FL
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Zip | 34228-3011
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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. ALEXANDER FINE
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Credential | MD
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Telephone | 267-312-6283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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