Individual provider Active NPI

Mojdeh Rabbani, M.D.

  • Internal Medicine Physician
  • Leesburg, FL
National Provider Identifier
1417993403
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME87075 Issued in FL
Practice address
711 W Main St
Leesburg, FL 34748-5128
Phone
(352) 435-4000
Fax
(352) 435-4016
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME87075 FL Primary

Addresses

Primary practice location

711 W Main St
Leesburg, FL 34748-5128

Mailing address

1031 Urico Golf Rd
Lady Lake, FL 32159-4425
Phone (352) 753-4478

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110113000644 FL Practitioner - Internal Medicine 8325072812 Practice locations: The Villages, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME87075FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417993403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 URICO GOLF RD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321594425",
            "telephone_number": "352-753-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W MAIN ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485128",
            "telephone_number": "352-435-4000",
            "fax_number": "352-435-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABBANI",
        "first_name": "MOJDEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME87075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.