| The Model Medical Group | |
|
333 W Cocoa Beach Cswy Ste D Cocoa Beach FL 32931-3513 | |
| (516) 384-1134 | |
| Not Available |
| Full Name | The Model Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 333 W Cocoa Beach Cswy Ste D, Cocoa Beach, Florida |
| Authorized Official Name and Position | Erica Monica Crew (ADMINISTRATOR) |
| Authorized Official Contact | 5163841134 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Model Medical Group 2555 Cox Rd Cocoa FL 32926-3525 Ph: (516) 384-1134 | The Model Medical Group 333 W Cocoa Beach Cswy Ste D Cocoa Beach FL 32931-3513 Ph: (516) 384-1134 |
| NPI Number | 1891359162 |
|---|---|
| Provider Enumeration Date | 04/23/2019 |
| Last Update Date | 04/23/2019 |
| Medicare PECOS PAC ID | 0345577433 |
|---|---|
| Medicare Enrollment ID | O20190813000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891359162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Erica Monica Crew |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538312988 PECOS PAC ID: 6608186937 Enrollment ID: I20180412000394 |
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