Healthcare Provider Details

I. General information

NPI: 1013183805
Provider Name (Legal Business Name): MOISES L HARATZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 10/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NE 123RD ST SUITE 414
NORTH MIAMI FL
33181-2817
US

IV. Provider business mailing address

900 S PINE ISLAND RD SUITE 800
PLANTATION FL
33324-3920
US

V. Phone/Fax

Practice location:
  • Phone: 305-981-0600
  • Fax: 305-981-2700
Mailing address:
  • Phone: 305-981-0600
  • Fax: 305-981-2700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME98411
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: