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NPI Code Detail

MEDICARE: MOSAIC MEDICAL, P.C.

MEDICARE: MOSAIC MEDICAL, P.C.
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
1207LP2900XPain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number : 1497043400
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOSAIC MEDICAL, P.C.
Provider Business Mailing Address
First Line : PO BOX 781299
Second Line :
City : SEBASTIAN
State : FL
Zip : 32978-1299
Country : US
Telephone Number : 772-581-6226
Fax Number :
Provider Business Practice Location Address
First Line : 4738 BROADWAY
Second Line :
City : NEW YORK
State : NY
Zip : 10040-1103
Country : US
Telephone Number : 800-853-4570
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : RICK ROMOLO
Credential :
Telephone Number : 772-538-4047
Provider Enumeration Date : 07/12/2011
Last Update Date : 07/12/2011

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Directions to “MOSAIC MEDICAL, P.C. ” Practice Location

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