MEDICARE: DR. GOPAL GADODIA 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
1	207RC0000X	Cardiovascular Disease Physician	ME57616	FL
2	207RI0011X	Interventional Cardiology Physician	ME57616	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1306842984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GOPAL GADODIA M.D.

Provider Business Mailing Address
First Line	:	2200 W EAU GALLIE BLVD
Second Line	:	STE 200
City	:	MELBOURNE
State	:	FL
Zip	:	32935-3166
Country	:	US
Telephone Number	:	321-255-1500
Fax Number	:	321-254-0400

Provider Business Practice Location Address
First Line	:	2200 W EAU GALLIE BLVD
Second Line	:	STE 200
City	:	MELBOURNE
State	:	FL
Zip	:	32935-3166
Country	:	US
Telephone Number	:	321-255-1500
Fax Number	:	321-254-0400

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	10/25/2023

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Directions to “ DR. GOPAL GADODIA M.D.” Practice Location

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