| Golden Mobile Medical Management Inc | |
|
958 Sw Martin Downs Blvd Palm City FL 34990-2816 | |
| (772) 223-6410 | |
| (772) 223-0092 |
| Full Name | Golden Mobile Medical Management Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 958 Sw Martin Downs Blvd, Palm City, Florida |
| Authorized Official Name and Position | Rebecca Prostko (OWNER) |
| Authorized Official Contact | 7722236410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Mobile Medical Management Inc 958 Sw Martin Downs Blvd Palm City FL 34990-2816 Ph: (772) 223-6410 | Golden Mobile Medical Management Inc 958 Sw Martin Downs Blvd Palm City FL 34990-2816 Ph: (772) 223-6410 |
| NPI Number | 1669929592 |
|---|---|
| Provider Enumeration Date | 09/08/2016 |
| Last Update Date | 02/27/2017 |
| Medicare PECOS PAC ID | 7214214170 |
|---|---|
| Medicare Enrollment ID | O20170501002421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669929592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME52247 (Florida) | Primary |
| Provider Name | Rebecca A Prostko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437124914 PECOS PAC ID: 6800883596 Enrollment ID: I20040428000172 |
| Provider Name | Walter D Devault |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700979515 PECOS PAC ID: 0244251999 Enrollment ID: I20051209000507 |
| Provider Name | Kenneth Holling |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396737516 PECOS PAC ID: 5496870719 Enrollment ID: I20100909001259 |
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