Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 2020040602 | MO |
N | 207T00000X | Neurosurgeon | 57.009925 | OH |
Y | 207T00000X | Neurosurgeon | ME138176 | FL |
NPI | 1013125913 |
---|---|
Provider Name | Mr. Kaveh Asadi-Moghaddam |
First Address | Clearwater, FL 33759-3012 |
Second Address | Tampa, FL 33607-6001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 04/10/2021 |