Provider Demographics
NPI:1356802029
Name:MOUREIDEN, MOUWAFAK (MD)
Entity type:Individual
Prefix:
First Name:MOUWAFAK
Middle Name:
Last Name:MOUREIDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6850 LAKE NONA BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7408
Mailing Address - Country:US
Mailing Address - Phone:407-266-1000
Mailing Address - Fax:407-266-1199
Practice Address - Street 1:11325 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34613-5407
Practice Address - Country:US
Practice Address - Phone:352-596-6333
Practice Address - Fax:352-596-0043
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2024-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME162233207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology