# PATRICIA MODAD, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Palm Coast OB GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942590401
- **Authorized official:** DR. PATRICIA ISABEL MODAD MD (PRESIDENT)
- **Authorized official phone:** (386) 447-6831

## Contact information

- **Practice address:** 50 LEANNI WAY, SUITES A3 & A4, PALM COAST, FL 32137-4751
- **Practice address phone:** (386) 447-6831
- **Practice address fax:** (386) 447-6834
- **Mailing address:** 50 LEANNI WAY, SUITES A3 & A4, PALM COAST, FL 32137-4751
- **Mailing address phone:** (386) 447-6831
- **Mailing address fax:** (386) 447-6834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME 103310 | FL | Yes |

## Other

- **Enumeration date:** 04/18/2011
- **Last updated:** 12/06/2011