| Parwati Maddali Md Professional Association | |
|
845 Executive Ln 100 Rockledge FL 32955-3528 | |
| (321) 631-4222 | |
| (321) 631-4302 |
| Full Name | Parwati Maddali Md Professional Association |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 845 Executive Ln, Rockledge, Florida |
| Authorized Official Name and Position | Parwati C Maddali (PRESIDENT) |
| Authorized Official Contact | 3216314222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parwati Maddali Md Professional Association Po Box 561527 Rockledge FL 32956-1527 Ph: (321) 631-4222 | Parwati Maddali Md Professional Association 845 Executive Ln 100 Rockledge FL 32955-3528 Ph: (321) 631-4222 |
| NPI Number | 1184745788 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 10/10/2013 |
| Medicare PECOS PAC ID | 0446164867 |
|---|---|
| Medicare Enrollment ID | O20031118001012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184745788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME0066568 (Florida) | Primary |
| Provider Name | Parwati C Maddali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669475497 PECOS PAC ID: 5597660977 Enrollment ID: I20120119000221 |
| Provider Name | Sajida Mathew |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164510509 PECOS PAC ID: 1850284233 Enrollment ID: I20140822001363 |
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