Individual
ERIC SARKIS MUDAFORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 34TH DR W, PALMETTO, FL 34221-2553
(941) 962-9791
Mailing address
PO BOX 474, TERRA CEIA, FL 34250-0474
(941) 962-9791
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME56921
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00448
UNIVERSAL MEDICARE MASTERPIECE
FL
01
—
10311
BCBS
FL
01
—
191910
AMERIGROUP
FL
01
—
202561
WELLCARE
FL
05
—
260804900
—
FL
01
—
836514
UNITED HEALTHCARE
FL
01
—
P00017940
RAILROAD
FL
01
—
P102210
FREEDOM HEALTH
FL
Enumeration date
03/02/2006
Last updated
07/21/2022
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