JOSEPH SAMUEL MOAK III (NPI# 1164867644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164867644 |
| Entity Type | Individual |
| Full Name | JOSEPH SAMUEL MOAK III |
| Credential | M.D. |
| Practice Address |
1819 Salk Ave Tavares FL 32778-4311 |
| Mailing Address |
601 E Dixie Ave Ste 901 Leesburg FL 34748-5998 |
| Practice Telephone | 3523437279 |
| Practice Fax Number | 3523431618 |
| Mailing Telephone | 3527282404 |
| Mailing Fax Number | 3527877401 |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2019-07-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
ME141155 | FL | Allopathic & Osteopathic Physicians |
| N | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
ME141155 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922627504 | Joseph Dylan Moak | Pharmacist | 5325 Atlanta Hwy, Flowery Branch, GA 30542-3336 | 2020-04-13 |
| 1184667800 | Joseph Samuel Moak Jr. | Internal Medicine | 2500 North State Street, Department of Medicine Div General Internal Medicine, Jackson, MS 39216-4500 | 2006-06-13 |
| Street Address |
1819 SALK AVE |
| City | TAVARES |
| State | FL |
| Zip Code | 32778-4311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073979795 | Megan Mann | Hearing Instrument Specialist | 1819 Salk Ave, Suite 2, Tavares, FL 32778-4311 | 2016-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487173753 | Erica Denise Irvin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4681 Marsh Harbor Dr, Tavares, FL 32778 | 2017-09-18 |
| 1922522499 | J&t Divine Care | Home Health | 1554 Auburn Hills Ct, Tavares, FL 32778 | 2017-07-27 |
| 1841738721 | Kelli Maragh | Behavior Technician | 12237 Tavares Ridge Circle, Tavares, FL 32778 | 2017-02-10 |
| 1831633692 | Amanda Williams Sellers | Nurse Practitioner | 1858 Mayo Dr, Tavares, FL 32778 | 2016-12-13 |
| 1235680042 | Natalie Roaine Ash-maheux | Occupational Therapist | 4501 Waterman Way, Tavares, FL 32778 | 2016-10-17 |
| 1396295713 | Sumiko Burley- Collins | Community Health Worker | 1572 Auburn Hills Court, Tavares, FL 32778 | 2016-10-10 |
| 1295100980 | Sunshine Therapy Group, Pa | Speech-Language Pathologist | 2050 Classique Lane, Tavares, FL 32778 | 2015-12-06 |
| 1093188385 | Jana Michelle England | Counselor | 1300 Duncan, Tavares, FL 32778 | 2015-11-09 |
| 1467865980 | Reshma Balmick | Hearing Instrument Specialist | 500 West Burleigh Blvd., Tavares, FL 32778 | 2014-06-03 |
| 1861825739 | Shelagh Kathryn Wood-gouveia | Nurse Practitioner | 1390 East Burleigh Blvd., Tavares, FL 32778 | 2013-08-15 |
| Find all providers in zip 32778 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093228587 | Cosmetic Medicine Enterprises Inc | Otolaryngology | 34156 Us Hwy 19 N, Palm Harbor, FL 34684 | 2017-11-07 |
| 1205362183 | Clifton Bridges | Otolaryngology | 6970 Sunnyside Dr, Leesburg, FL 34748-9556 | 2017-05-11 |
| 1811305568 | Medney Tardy Jr. | Otolaryngology | 651 Jacana Cir, Naples, FL 34105-7400 | 2014-07-25 |
| 1699113605 | Lebeau Clinic Pl | Otolaryngology | 1020 N Palafox St, Pensacola, FL 32501-3118 | 2013-06-12 |
| 1750661328 | Jesse Andrew Burnam | Otolaryngology | 15647 Carriedale Ln, Fort Myers, FL 33912-3904 | 2011-08-26 |
| 1619276102 | Thomas Lewis Tzikas | Otolaryngology | 526 Se 5th Ave, Delray Beach, FL 33483-5213 | 2011-03-23 |
| 1356595268 | Vijay M Sharma | Otolaryngology | 601 University Blvd Ste 201, Jupiter, FL 33458-2788 | 2008-11-05 |
| 1881846731 | Anthony Bared | Otolaryngology | 6280 Sunset Dr Ste 504, South Miami, FL 33143-4870 | 2008-10-22 |
| 1700034345 | Larry Nelson Smith | Otolaryngology | 10925 Sw 27th Ave, Gainesville, FL 32608-8937 | 2008-09-08 |
| 1821251216 | Jean-paul Azzi | Otolaryngology | 4495 Military Trl Ste 202, The Palm Beach Center for Facial Plastic and Laser Surg, Jupiter, FL 33458-4818 | 2008-07-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.