Provider Demographics
NPI:1033130976
Name:YALON, MOSHE (MD)
Entity Type:Individual
Prefix:
First Name:MOSHE
Middle Name:
Last Name:YALON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE N
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4834
Mailing Address - Country:US
Mailing Address - Phone:954-457-7445
Mailing Address - Fax:954-456-7469
Practice Address - Street 1:2500 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE N
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4834
Practice Address - Country:US
Practice Address - Phone:954-457-7445
Practice Address - Fax:954-456-7469
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 50141207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650160719OtherCIGNA
FL650160719OtherAETNA
FL650160719OtherUNITED
FL07761OtherBLUE CROSS BLUE SHEILD
FL054701801Medicaid
FL07761OtherBLUE CROSS BLUE SHEILD
FLE21416Medicare UPIN