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NPI Code Detail

MEDICARE: DR. SHIRLY S MOONJELI M.D.

MEDICARE: DR. SHIRLY S MOONJELI 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
1207Q00000XFamily Medicine PhysicianME87676FL

General Provider Information

NPI Number : 1992707244
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHIRLY S MOONJELI M.D.
Provider Business Mailing Address
First Line : 13000 BRUCE B DOWNS BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-4745
Country : US
Telephone Number : 813-972-2000
Fax Number : 813-903-4810
Provider Business Practice Location Address
First Line : 13000 BRUCE B DOWNS BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-4745
Country : US
Telephone Number : 813-972-2000
Fax Number : 813-903-4810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 06/02/2011

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