MEDICARE: ROBERT D MOURADIAN PA

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

General Provider Information

NPI Number	:	1437374923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT D MOURADIAN PA

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	:	OWNER
Name	:	ROBERT MOURADIAN
Credential	:	MD
Telephone Number	:	904-476-3616

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	04/17/2020

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Directions to “ROBERT D MOURADIAN PA ” Practice Location

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