Individual ProviderPrasanth GogineniInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address660 Glades Rd Ste 140, Boca Raton, FL 33431-6466(561) 800-4570(561) 800-2601PECOS EnrollmentBased on the most recent information from CMS, provider Prasanth Gogineni is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1376641902Provider TypeIndividualFull NameGogineni, PrasanthTitleDr.CredentialMDGenderMaleSole ProprietorYesEnumeration Date9/20/2006Last Updated3/19/2024Contact InformationPractice LocationPractice Address660 Glades Rd Ste 140, Boca Raton, FL 33431-6466Phone(561) 800-4570Fax(561) 800-4580Mailing LocationMailing Address660 Glades Rd Ste 140, Boca Raton, FL 33431-6466Phone(561) 800-2601FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseME131492FloridaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseME131492FloridaProvider IdentifiersIDDescriptionIssuerIDME131492DescriptionOtherIssuerMEDICAL LICENSEFlorida