MEDICARE: OASIS MEDICAL INSTITUTE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME0041701	FL

General Provider Information

NPI Number	:	1174711998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS MEDICAL INSTITUTE, INC

Provider Business Mailing Address
First Line	:	5854 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-3363
Country	:	US
Telephone Number	:	305-267-8111
Fax Number	:	305-267-8734

Provider Business Practice Location Address
First Line	:	5854 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-3363
Country	:	US
Telephone Number	:	305-267-8111
Fax Number	:	305-267-8734

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID MOISES
Credential	:	MD
Telephone Number	:	305-267-8111

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	10/05/2007

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