Organization
MOIDEEN M MOOPEN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOIDEEN M MOOPEN MD (PHYSICIAN)
(941) 625-1391
Entity
Organization
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
ME35706
FL
207RG0100X
Gastroenterology Physician
Primary
ME35706
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08095
BCBS OF FLORIDA
FL
Enumeration date
01/31/2007
Last updated
09/22/2010
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