Provider Demographics
NPI:1922482405
Name:ALNABLSI, MOATAZ
Entity Type:Individual
Prefix:
First Name:MOATAZ
Middle Name:
Last Name:ALNABLSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 23RD ST NW
Mailing Address - Street 2:G 2092
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2342
Mailing Address - Country:US
Mailing Address - Phone:202-715-5236
Mailing Address - Fax:
Practice Address - Street 1:5955 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2423
Practice Address - Country:US
Practice Address - Phone:305-661-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMTL002697208000000X
FLME1424962080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics