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NPI Code Detail

MEDICARE: MIDWAY SPECIALTY CARE CENTER INC

MEDICARE: MIDWAY SPECIALTY CARE CENTER INC
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
1207RI0200XInfectious Disease Physician

Other Identifiers

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

General Provider Information

NPI Number : 1376970814
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDWAY SPECIALTY CARE CENTER INC
Provider Business Mailing Address
First Line : 356 E MIDWAY RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-7148
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 356 E MIDWAY RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-7148
Country : US
Telephone Number : 772-464-9746
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. MOTI N RAMGOPAL
Credential : MD
Telephone Number : 772-464-9746
Provider Enumeration Date : 09/30/2013
Last Update Date : 09/02/2020

Similar Medicare Providers

1801884028 — MS. DARLA L BAGWELL ARNP
Practice Location Address:
356 E MIDWAY RD
FORT PIERCE, FL
34982-7148
Practice Phone: 772-464-9746
Practice Fax: 772-464-9750
1457329450 — MR. MOTI N RAMGOPAL MD
Practice Location Address:
356 E MIDWAY RD
FORT PIERCE, FL
34982-7148
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Practice Fax: 772-464-9750
1538138599 — MRS. BRENDA L JACOBS ARNP
Practice Location Address:
356 E MIDWAY RD
FORT PIERCE, FL
34982-7148
Practice Phone: 772-464-9746
Practice Fax: 772-464-9750
1245355866 — MS. RANDI BETH FREEDMAN RD, LDN
Practice Location Address:
356 E MIDWAY RD
FORT PIERCE, FL
34982-7148
Practice Phone: 908-300-6081
Practice Fax:
1356580518 — MIDWAY IMMUNOLOGY AND RESEARCH CENTER
Practice Location Address:
356 E MIDWAY RD
FORT PIERCE, FL
34982-7148
Practice Phone: 772-464-9746
Practice Fax:
1447544408 — MOTI RAMGOPAL MDPA
Practice Location Address:
356 E MIDWAY RD
FORT PIERCE, FL
34982-7148
Practice Phone: 772-464-9746
Practice Fax: 772-464-9750

Directions to “MIDWAY SPECIALTY CARE CENTER INC ” Practice Location

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