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Individual

STEPHANIE A MOAWAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 334-0206
(352) 334-4041
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 334-0206
(352) 334-4041

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35-087012
OH
208000000X
Pediatrics Physician
Primary
ME106579
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002796500
FL
05
2670999
OH
Enumeration date
12/20/2006
Last updated
12/09/2011
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