Individual
MOUDAR ALSHAZLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4225 WOODBINE RD, SUITE A, PACE, FL 32571-8790
(850) 994-6575
(850) 994-5643
Mailing address
4225 WOODBINE RD, SUITE A, PACE, FL 32571-8790
(850) 994-6575
(850) 994-5643
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME78728
FL
207Q00000X
Family Medicine Physician
ME78728
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263433300
—
FL
Enumeration date
05/14/2006
Last updated
02/02/2011
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