Provider Demographics
NPI:1013151141
Name:GOLAWALA, MUSHFEKA MOIZ (MD)
Entity Type:Individual
Prefix:MRS
First Name:MUSHFEKA
Middle Name:MOIZ
Last Name:GOLAWALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:MUSHFEKA
Other - Middle Name:ZAKIUDDIN
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20384 HACIENDA CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6603
Mailing Address - Country:US
Mailing Address - Phone:561-703-1383
Mailing Address - Fax:561-423-8372
Practice Address - Street 1:20384 HACIENDA CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6603
Practice Address - Country:US
Practice Address - Phone:561-703-1383
Practice Address - Fax:561-423-8372
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 103852207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine