Individual
DR. PATRICIA ISABEL MODAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., F.A.C.O.G.
Contact information
Practice address
50 LEANNI WAY, SUITES A3 & A4, PALM COAST, FL 32137-4751
(386) 447-6831
(386) 447-6834
Mailing address
P.O.BOX 351295, PALM COAST, FL 32137-1295
(386) 447-6831
(386) 447-6834
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01053870A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
ME103310
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001042100
—
FL
Enumeration date
07/22/2006
Last updated
12/06/2011
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