Provider Demographics
NPI:1659328243
Name:MOAWAD, NASHAT SAYED (MD)
Entity Type:Individual
Prefix:DR
First Name:NASHAT
Middle Name:SAYED
Last Name:MOAWAD
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:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-7673
Mailing Address - Fax:352-392-7488
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610
Practice Address - Country:US
Practice Address - Phone:352-273-7673
Practice Address - Fax:352-392-7488
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083637M207P00000X
OH35.083637207Q00000X, 207V00000X
PAMD433846207V00000X
FLME106191207V00000X, 207VX0000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00222396OtherMEDICARE TRAVELERS RR-GA
FL002108900Medicaid
OH2523568Medicaid
OH942460636894OtherCARESOURCE
OHI22931Medicare UPIN
OHP00222396OtherMEDICARE TRAVELERS RR-GA