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Organization

KIRAN R. MODI, M.D., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIRAN R MODI M.D. (PRESIDENT)
(321) 264-9100
Entity
Organization

Contact information

Practice address
500 N WASHINGTON AVE, SUITE # 106, TITUSVILLE, FL 32796-2759
(321) 264-9100
(321) 264-1164
Mailing address
500 N WASHINGTON AVE, SUITE # 106, TITUSVILLE, FL 32796-2759
(321) 264-9100
(321) 264-1164

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Enumeration date
11/03/2010
Last updated
11/03/2010
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