Provider Demographics
NPI:1316110513
Name:MORAD, MOHAMAD MUDAR (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:MUDAR
Last Name:MORAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13005 STATE ROAD 80 STE 141
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9231
Mailing Address - Country:US
Mailing Address - Phone:561-798-4600
Mailing Address - Fax:561-798-1132
Practice Address - Street 1:13005 STATE ROAD 80
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9206
Practice Address - Country:US
Practice Address - Phone:561-798-4600
Practice Address - Fax:561-798-1132
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.120202208M00000X
FLME118371207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist