Provider Demographics
NPI:1548321409
Name:MORA, FRANCISCO JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:JOSE
Last Name:MORA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14601 BALGOWAN RD APT 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6455
Mailing Address - Country:US
Mailing Address - Phone:305-820-6211
Mailing Address - Fax:305-822-0116
Practice Address - Street 1:7480 FAIRWAY DR
Practice Address - Street 2:STE #108
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6879
Practice Address - Country:US
Practice Address - Phone:305-820-6211
Practice Address - Fax:305-822-0116
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2019-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME34844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066069800Medicaid
FL100019700Medicaid
FLD64837Medicare UPIN