Individual
DR. MOBEEN HASAN RATHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP PEDIATRIC INFECTIOUS DISEASES, JACKSONVILLE, FL 32209-6511
(904) 244-8350
(904) 244-3896
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME60401
FL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
ME60401
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000468069C
—
GA
05
—
0550540-00
—
FL
01
—
370017074
RAILROAD MEDICARE
FL
Enumeration date
03/19/2006
Last updated
07/01/2009
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