MEDICARE: SUZET MOAWAD M.D

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	208M00000X	Hospitalist Physician	ME162050	FL

General Provider Information

NPI Number	:	1518411255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZET MOAWAD M.D

Provider Business Mailing Address
First Line	:	PO BOX 917770
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891-0001
Country	:	US
Telephone Number	:	813-821-8038
Fax Number	:	813-974-0483

Provider Business Practice Location Address
First Line	:	3001 W MLK BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6307
Country	:	US
Telephone Number	:	813-259-8857
Fax Number	:	813-554-8171

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

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	01/09/2026

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