| Hamidreza Moghaddam Md Pa | |
|
527 Ne 124th St North Miami FL 33161-5423 | |
| (305) 895-9233 | |
| (305) 895-9274 |
| Full Name | Hamidreza Moghaddam Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 527 Ne 124th St, North Miami, Florida |
| Authorized Official Name and Position | Hamidreza Moghaddam (OWNER) |
| Authorized Official Contact | 3058959233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hamidreza Moghaddam Md Pa 527 Ne 124th St North Miami FL 33161-5423 Ph: (305) 895-9233 | Hamidreza Moghaddam Md Pa 527 Ne 124th St North Miami FL 33161-5423 Ph: (305) 895-9233 |
| NPI Number | 1457300386 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 02/02/2016 |
| Medicare PECOS PAC ID | 3173535689 |
|---|---|
| Medicare Enrollment ID | O20060628000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457300386 | NPI | - | NPPES |
| 273130400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME91771 (Florida) | Primary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | PO3670 (Florida) | Secondary |
| Provider Name | Roya R Borjian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033120084 PECOS PAC ID: 6709829047 Enrollment ID: I20050607000907 |
| Provider Name | Hamidreza Moghaddam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477519122 PECOS PAC ID: 5092730028 Enrollment ID: I20051010000459 |
| Provider Name | Sarlette Jean-baptiste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730496324 PECOS PAC ID: 0446438642 Enrollment ID: I20110616000483 |
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