Provider Demographics
NPI:1619248358
Name:MOULAVI, SASSON E (MD)
Entity Type:Individual
Prefix:DR
First Name:SASSON
Middle Name:E
Last Name:MOULAVI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:190 GLADES RD
Mailing Address - Street 2:SUIT E
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1642
Mailing Address - Country:US
Mailing Address - Phone:561-445-4489
Mailing Address - Fax:561-338-4944
Practice Address - Street 1:3196 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6700
Practice Address - Country:US
Practice Address - Phone:561-338-3999
Practice Address - Fax:561-338-4944
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2020-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME83741208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice