MEDICARE: DR. ROBERT DAVID MOURADIAN MD

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	207L00000X	Anesthesiology Physician	35076224	OH
2	207L00000X	Anesthesiology Physician	ME75337	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275527756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT DAVID MOURADIAN MD

Provider Business Mailing Address
First Line	:	7629 SENTRY OAK CIR E
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-2323
Country	:	US
Telephone Number	:	904-476-3616
Fax Number	:

Provider Business Practice Location Address
First Line	:	9726 TOUCHTON RD STE 305
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-8307
Country	:	US
Telephone Number	:	904-686-6020
Fax Number	:	904-619-8879

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	04/16/2020

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Directions to “ DR. ROBERT DAVID MOURADIAN MD” Practice Location

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