| Midway Specialty Care Center Inc | |
|
356 E Midway Rd Fort Pierce FL 34982-7148 | |
| (772) 464-9746 | |
| Not Available |
| Full Name | Midway Specialty Care Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 356 E Midway Rd, Fort Pierce, Florida |
| Authorized Official Name and Position | Moti N Ramgopal (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7724649746 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midway Specialty Care Center Inc 356 E Midway Rd Fort Pierce FL 34982-7148 Ph: () - | Midway Specialty Care Center Inc 356 E Midway Rd Fort Pierce FL 34982-7148 Ph: (772) 464-9746 |
| NPI Number | 1376970814 |
|---|---|
| Provider Enumeration Date | 09/30/2013 |
| Last Update Date | 09/02/2020 |
| Medicare PECOS PAC ID | 9638306087 |
|---|---|
| Medicare Enrollment ID | O20131211000645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376970814 | NPI | - | NPPES |
| 009849200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Raja R. Talati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942254412 PECOS PAC ID: 7113820614 Enrollment ID: I20040131000007 |
| Provider Name | Claudio D Tuda |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497728620 PECOS PAC ID: 2062400971 Enrollment ID: I20040430001160 |
| Provider Name | Suzanne Y Succop |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1578583076 PECOS PAC ID: 9133100209 Enrollment ID: I20040525001329 |
| Provider Name | Hector Herney Bolivar |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1558398206 PECOS PAC ID: 6103874961 Enrollment ID: I20050107000693 |
| Provider Name | Raj Uttamchandani |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801859988 PECOS PAC ID: 9739137456 Enrollment ID: I20050110000840 |
| Provider Name | Daniel Warner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285608299 PECOS PAC ID: 7911975271 Enrollment ID: I20050222000119 |
| Provider Name | Lorraine M Dowdy |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1760445944 PECOS PAC ID: 5799708889 Enrollment ID: I20060104000216 |
| Provider Name | Cynthia I Rivera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285835520 PECOS PAC ID: 5395831598 Enrollment ID: I20071126000065 |
| Provider Name | Esther C Schumann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528194438 PECOS PAC ID: 9537241039 Enrollment ID: I20080123000296 |
| Provider Name | Jose Alberto Giron |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1265619266 PECOS PAC ID: 5294739454 Enrollment ID: I20100726000228 |
| Provider Name | Jennifer Lynne Kuretski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184950404 PECOS PAC ID: 8426242942 Enrollment ID: I20101028001256 |
| Provider Name | Michael Dunn |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1760477442 PECOS PAC ID: 0941486476 Enrollment ID: I20110518000654 |
| Provider Name | Brenda Lee Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538138599 PECOS PAC ID: 0648456046 Enrollment ID: I20110519000621 |
| Provider Name | Moti N Ramgopal |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457329450 PECOS PAC ID: 5092740563 Enrollment ID: I20110525000143 |
| Provider Name | Berjan Collin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457329468 PECOS PAC ID: 7315123494 Enrollment ID: I20110526000039 |
| Provider Name | Darla Bagwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801884028 PECOS PAC ID: 4587806344 Enrollment ID: I20130924000502 |
| Provider Name | Anamaria Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417396672 PECOS PAC ID: 8426286766 Enrollment ID: I20140114000771 |
| Provider Name | Oscar Martinez Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104104264 PECOS PAC ID: 1254558067 Enrollment ID: I20140818002015 |
| Provider Name | Isabel Cristina Gomez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1558652461 PECOS PAC ID: 5698083715 Enrollment ID: I20151008002477 |
| Provider Name | Terry Y Law |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063828903 PECOS PAC ID: 0446479612 Enrollment ID: I20160622001698 |
| Provider Name | Howard Grossman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710951694 PECOS PAC ID: 4284795287 Enrollment ID: I20161020000178 |
| Provider Name | Alisha Christie Elizabeth Azemar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699220277 PECOS PAC ID: 7012295462 Enrollment ID: I20161105000184 |
| Provider Name | Frances P Holliday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033378526 PECOS PAC ID: 9133405020 Enrollment ID: I20170406003055 |
| Provider Name | Bertamaria Dieguez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447681846 PECOS PAC ID: 8628323136 Enrollment ID: I20180622002240 |
| Provider Name | Nicholas S Camps |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1720320955 PECOS PAC ID: 7911243894 Enrollment ID: I20190114002835 |
| Provider Name | Theresa W Dryden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164408233 PECOS PAC ID: 2961491766 Enrollment ID: I20191004000762 |
| Provider Name | Renette Gabriel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982002788 PECOS PAC ID: 6103251814 Enrollment ID: I20200127000454 |
| Provider Name | Ashley L Quidaciolu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245898865 PECOS PAC ID: 5698101939 Enrollment ID: I20200205002489 |
| Provider Name | Vincenzo Scotto D Antuono |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811962855 PECOS PAC ID: 7618963513 Enrollment ID: I20200325000049 |
| Provider Name | Rodrigo Sabec |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063012938 PECOS PAC ID: 3870905284 Enrollment ID: I20201209000171 |
| Provider Name | Emmanuelle Allseits |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376906438 PECOS PAC ID: 0345536116 Enrollment ID: I20210820002623 |
| Provider Name | Kara N Kempf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649943861 PECOS PAC ID: 7416354964 Enrollment ID: I20210925000060 |
| Provider Name | Steven M Cardenas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376212050 PECOS PAC ID: 9032517602 Enrollment ID: I20211012002527 |
| Provider Name | Michael T Romeo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740860964 PECOS PAC ID: 6002204302 Enrollment ID: I20211019000910 |
| Provider Name | Joao C Rodrigues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093332140 PECOS PAC ID: 4082008347 Enrollment ID: I20220302001440 |
| Provider Name | Candice T Joseph |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700232667 PECOS PAC ID: 1557690765 Enrollment ID: I20220503002542 |
| Provider Name | Lizy M Paniagua Gonzalez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1427585256 PECOS PAC ID: 8426411273 Enrollment ID: I20230828002425 |
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