Provider Demographics
NPI:1275578734
Name:MOON, MUSARRAT PASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:MUSARRAT
Middle Name:PASHA
Last Name:MOON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7448 DOCS GROVE CIR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8010
Mailing Address - Country:US
Mailing Address - Phone:407-352-1303
Mailing Address - Fax:407-352-3833
Practice Address - Street 1:7448 DOCS GROVE CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8010
Practice Address - Country:US
Practice Address - Phone:407-352-1303
Practice Address - Fax:407-352-3833
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0074705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42798Medicare ID - Type Unspecified
FLG13756Medicare UPIN