Healthcare Provider Details

I. General information

NPI: 1518411255
Provider Name (Legal Business Name): SUZET MOAWAD M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 W MLK BLVD
TAMPA FL
33607-6307
US

IV. Provider business mailing address

PO BOX 917770
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 813-259-8857
  • Fax: 813-554-8171
Mailing address:
  • Phone: 813-821-8038
  • Fax: 813-974-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME162050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: