Provider Demographics
NPI:1013183805
Name:HARATZ, MOISES L (MD)
Entity Type:Individual
Prefix:
First Name:MOISES
Middle Name:L
Last Name:HARATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:305-981-0600
Mailing Address - Fax:305-981-2700
Practice Address - Street 1:1801 NE 123RD ST
Practice Address - Street 2:SUITE 414
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2817
Practice Address - Country:US
Practice Address - Phone:305-981-0600
Practice Address - Fax:305-981-2700
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2015-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME98411208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004693300Medicaid