Individual
DR. MOHAMMAD (MICHAEL) REZA MASSOOMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, BOX 100277, GAINESVILLE, FL 32610-3003
(352) 273-9089
Mailing address
PO BOX 100277, GAINESVILLE, FL 32610-0277
(352) 273-9065
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME128196
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME128196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017906300
—
FL
Enumeration date
05/04/2009
Last updated
03/07/2017
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