Organization
CLAY PRIMARY & FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASSOUD MOSHIREE M.D. (PRESIDENT/OWNER)
(904) 276-1133
Entity
Organization
Contact information
Practice address
865 BLANDING BLVD, ORANGE PARK, FL 32065-8917
(904) 276-1133
(904) 276-1821
Mailing address
865 BLANDING BLVD, ORANGE PARK, FL 32065-8917
(904) 276-1133
(904) 276-1821
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255561100
—
FL
Enumeration date
07/06/2005
Last updated
07/21/2022
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