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NPI Code Detail

MEDICARE: DR. PAUL J. CIMOCH M.D.

MEDICARE: DR. PAUL J. CIMOCH M.D.
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
1208M00000XHospitalist PhysicianME154455FL
2207R00000XInternal Medicine PhysicianME154455FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3WA46088COTHERCAMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093793853
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL J. CIMOCH M.D.
Provider Business Mailing Address
First Line : 1700 S 23RD ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-4803
Country : US
Telephone Number : 714-206-6868
Fax Number : 772-468-4497
Provider Business Practice Location Address
First Line : 1700 S 23RD ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-4803
Country : US
Telephone Number : 714-206-6868
Fax Number : 772-468-4497
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 09/13/2024

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