Provider Demographics
NPI:1104089960
Name:MOSCARDINI, DAHLIA CINDY (MBBS, MPH)
Entity type:Individual
Prefix:DR
First Name:DAHLIA
Middle Name:CINDY
Last Name:MOSCARDINI
Suffix:
Gender:F
Credentials:MBBS, MPH
Other - Prefix:DR
Other - First Name:DAHLIA
Other - Middle Name:CINDY
Other - Last Name:MOSCARDINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:3401 PGA BLVD
Mailing Address - Street 2:STE #300
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-741-0000
Mailing Address - Fax:561-741-0002
Practice Address - Street 1:3401 PGA BLVD
Practice Address - Street 2:STE #300
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-741-0000
Practice Address - Fax:561-741-0002
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64676208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018596900Medicaid
GA551856953AMedicaid