MEDICARE: MR. DAN MOLDOVEANU 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	207R00000X	Internal Medicine Physician	047494	GA
2	207R00000X	Internal Medicine Physician	ME120993	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	52748909859	OTHER	GA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P00651138	OTHER	GA	RRMCA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952372179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAN MOLDOVEANU M.D.

Provider Business Mailing Address
First Line	:	133 BENMORE DR
Second Line	:	SUITE 200
City	:	WINTER PARK
State	:	FL
Zip	:	32792-4111
Country	:	US
Telephone Number	:	407-646-7070
Fax Number	:	407-646-7747

Provider Business Practice Location Address
First Line	:	133 BENMORE DR
Second Line	:	SUITE 200
City	:	WINTER PARK
State	:	FL
Zip	:	32792-4111
Country	:	US
Telephone Number	:	407-646-7070
Fax Number	:	407-646-7747

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	07/20/2015

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