Provider Demographics
NPI:1265478523
Name:MOSKOWITZ, STEPHEN ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ERIC
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1881 UNIVERSITY DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6098
Mailing Address - Country:US
Mailing Address - Phone:954-345-7474
Mailing Address - Fax:954-345-4003
Practice Address - Street 1:1881 UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6098
Practice Address - Country:US
Practice Address - Phone:954-345-7474
Practice Address - Fax:954-345-4003
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME218632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL95351Medicare ID - Type Unspecified
E14715Medicare UPIN