| Md 2 Go Llc | |
|
1801 Se Hillmoor Dr B109 Port Saint Lucie FL 34952-7553 | |
| (772) 337-9473 | |
| (772) 337-0796 |
| Full Name | Md 2 Go Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1801 Se Hillmoor Dr, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Dwight G Dawkins (OWNER) |
| Authorized Official Contact | 7723379473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md 2 Go Llc 1801 Se Hillmoor Dr B109 Port Saint Lucie FL 34952-7553 Ph: (772) 337-9473 | Md 2 Go Llc 1801 Se Hillmoor Dr B109 Port Saint Lucie FL 34952-7553 Ph: (772) 337-9473 |
| NPI Number | 1457696601 |
|---|---|
| Provider Enumeration Date | 11/29/2012 |
| Last Update Date | 11/29/2012 |
| Medicare PECOS PAC ID | 1759528532 |
|---|---|
| Medicare Enrollment ID | O20130515000320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457696601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dwight Garfield Dawkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164492005 PECOS PAC ID: 5991849507 Enrollment ID: I20100220000253 |
| Provider Name | Gregory A Dawkins |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235336819 PECOS PAC ID: 5496936643 Enrollment ID: I20121008000013 |
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