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Organization
DIXITKUMAR N MODI MD PA
Active
Organization
DIXITKUMAR N MODI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIXITKUMAR NAVINCHANDRA MODI MD (OWNER)
(334) 327-9530
Entity
Organization
Contact information
Practice address
4350 N ATLANTIC AVE, COCOA BEACH, FL 32931-3656
(334) 327-9530
Mailing address
3003 TRASONA DR, MELBOURNE, FL 32940-7670
(321) 613-5352
(321) 613-5356
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
08/20/2019
Last updated
02/23/2024
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