Provider Demographics
NPI:1225030513
Name:GO POPAT, DARLENE (MD)
Entity Type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:
Last Name:GO POPAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DARLENE
Other - Middle Name:M
Other - Last Name:GO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:240 N WICKHAM RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-8660
Mailing Address - Country:US
Mailing Address - Phone:321-541-1746
Mailing Address - Fax:321-676-2613
Practice Address - Street 1:240 N WICKHAM RD STE 202
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8660
Practice Address - Country:US
Practice Address - Phone:321-541-1746
Practice Address - Fax:321-676-2613
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79752207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060060563OtherRAILROAD MEDICARE
FL258570700Medicaid
FL258570700Medicaid
FL49689ZMedicare PIN