Stephanie A Moawad, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME106579 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 334-0206

Fax

(352) 334-4041

NPI assigned

Dec 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1164586558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-334-0206",
            "fax_number": "352-334-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-334-0206",
            "fax_number": "352-334-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAWAD",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-087012",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME106579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2670999",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002796500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael James Miyashiro, MD
• Amie Danielle Mizell, PHARMD, RPH
• MK Healthcare, LLC
• Daniel Moates
• Nashat Sayed Moawad, MD
• Jeanne M Moberly, PHD
• Mobile Nuclear Imaging, LLC
• Andrea M Mobley
• Lorraine Mobley
• Mallory Mobley

• Pediatrics Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.