DR. MOGHADASI & ASSOCIATES, PA
Managed Care Organizations at Us Highway 98, Lakeland, FL

License number
Florida DN13330
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: FARID MOGHADASI DMD
Title: OWNER
Phone: (863) 858-7600
Address
Address
5608 Us Highway 98 N, Lakeland, FL 33809
National Provider ID: 1013265719
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DR. MOGHADASI & ASSOCIATES, PA

Lakeland, FL

Registration:
Dec 3, 1997
Addresses:
5608 U.s Hwy 98 N, Lakeland, FL 33809 (Physical)
5608 Us Hwy 98 N, Lakeland, FL 33809
State ID:
P97000101865
Business type:
Florida Profit Corporation
President, Treasurer, Secretary:
Farid Moghadasi (President, Treasurer, Secretary), 5608 U.s Hwy 98 N, Lakeland, FL 33809 (Physical)
Agent:
Mark Turner,255 Magnolia Ave SW, Winter Haven, FL 33880 (Physical)
EIN:
59-3480699

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