MEDICARE: MEDIKWA, 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
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1518837715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDIKWA, INC

Provider Business Mailing Address
First Line	:	PO BOX 3979
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34230-3979
Country	:	US
Telephone Number	:	941-921-7744
Fax Number	:	941-388-7051

Provider Business Practice Location Address
First Line	:	306 WHITFIELD AVE
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-1526
Country	:	US
Telephone Number	:	941-921-7745
Fax Number	:	941-921-7744

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	JANICE R WADE
Credential	:
Telephone Number	:	941-921-7744

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	01/29/2026

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Directions to “MEDIKWA, INC ” Practice Location

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