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General NPI Number Information
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NPI Number | 1619668407
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Entity Type | Organization
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Legal Business Name | USAI MED LLC
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 3196 N FEDERAL HWY STE A
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City | BOCA RATON
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State | FL
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Zip | 33431-6700
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Country | US
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Telephone | 561-445-4489
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Fax |
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Provider Business Mailing Address
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Address Line | 3196 N FEDERAL HWY STE A
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City | BOCA RATON
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State | FL
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Zip | 33431-6700
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Country | US
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Telephone | 561-445-4489
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/ OWNER
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Name | SASSON E MOULAVI
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Credential | MD
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Telephone | 561-445-4489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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