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Individual

JOHN WILLIAM GREY MODICA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
975 BAPTIST WAY, HOMESTEAD, FL 33033-7600
(786) 243-8000
Mailing address
117 MASON RD, BROOKLYN, CT 06234-2442

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
84252
GA
207P00000X
Emergency Medicine Physician
Primary
ME142161
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/02/2016
Last updated
03/06/2026
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