Doctor Name: | DEBBIE LYNN MOULAVI |
NPI Number: | 1073505459 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP C |
License Number: | 1498402 |
Business Practice Address: | 2284 Red Ember Rd Oviedo, FL - 327659763 |
Business Phone Number: | 4073596426 |
Business Fax Number: | 4073596426 |
Mailing Address: | 2284 Red Ember Rd, OVIEDO |
State: | FL |
Postal Code: | 327659763 |
Phone Number: | 4073596426 |
Fax Number: | 4073596426 |
NPI Enumeration Date: | 08/22/2005 |
NPI Last Update Date: | 01/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1498402 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |