Provider Demographics
NPI:1467984146
Name:BRAIMOH, MOSES (MD)
Entity Type:Individual
Prefix:
First Name:MOSES
Middle Name:
Last Name:BRAIMOH
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 1:800 CLEMATIS ST STE 5-531
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5107
Mailing Address - Country:US
Mailing Address - Phone:561-514-5300
Mailing Address - Fax:561-514-5538
Practice Address - Street 1:809 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-1884
Practice Address - Country:US
Practice Address - Phone:337-233-2437
Practice Address - Fax:337-233-7179
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1435652083P0901X
LA338804207Q00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine