Organization
MIDWAY SPECIALTY CARE CENTER INC
Active
Organization
MIDWAY SPECIALTY CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOTI N RAMGOPAL MD (MEDICAL DIRECTOR)
(772) 464-9746
Entity
Organization
Contact information
Practice address
356 E MIDWAY RD, FORT PIERCE, FL 34982-7148
(772) 464-9746
Mailing address
356 E MIDWAY RD, FORT PIERCE, FL 34982-7148
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009849200
—
FL
Enumeration date
09/30/2013
Last updated
09/02/2020
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