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NPI Code Detail

MEDICARE: MOTI RAMGOPAL MDPA

MEDICARE: MOTI RAMGOPAL MDPA
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 PhysicianME70180FL

General Provider Information

NPI Number : 1447544408
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOTI RAMGOPAL MDPA
Provider Business Mailing Address
First Line : 10302 S FEDERAL HWY
Second Line : STE 265
City : PORT ST LUCIE
State : FL
Zip : 34952-5605
Country : US
Telephone Number : 772-464-9746
Fax Number : 772-464-9750
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 : 772-464-9750
Authorized Official
Title or Position : CEO
Name : DR. MOTI RAMGOPAL
Credential : MD
Telephone Number : 772-464-9746
Provider Enumeration Date : 06/07/2011
Last Update Date : 06/07/2011

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