Individual
MOIDEEN M MOOPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 HARBOR BLVD, SUITE #19, PORT CHARLOTTE, FL 33952-5038
(941) 625-1391
(941) 624-0635
Mailing address
2400 HARBOR BLVD, SUITE #19, PORT CHARLOTTE, FL 33952-5038
(941) 625-1391
(941) 624-0635
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME 35706
FL
207RG0100X
Gastroenterology Physician
Primary
ME 35706
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08095
BCBS OF FLORIDA
FL
Enumeration date
08/25/2006
Last updated
08/24/2010
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