Provider Demographics
NPI:1588766521
Name:MOISE, JEFF (MD)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:MOISE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 ALTON ROAD, ASCHER BUILDING 2ND FLOOR
Mailing Address - Street 2:ATTEN: PHYSICIAN SERVICES
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2800
Mailing Address - Country:US
Mailing Address - Phone:305-674-2121
Mailing Address - Fax:305-535-7919
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:GREENE PAVILION, SUITE 301
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-674-2655
Practice Address - Fax:305-674-2208
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME90008207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology