Moss, Marilyn Carol
Moss, Marilyn Carol is an individual health care provider with primary practice located at 2100 N Wickham Rd , Melbourne FL 32935-8110. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Moss, Marilyn Carol can be contacted via phone (321) 752-7100.Contact Information
Primary practice address
2100 N Wickham Rd
Melbourne FL 32935-8110
Phone: (321) 752-7100
Fax: (321) 752-7105
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME22466 | Florida |
Profile Details
| NPI number | 1962405126 |
|---|---|
| LBN Legal business name | Moss, Marilyn Carol |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2005 |
| Last updated | Mar 20th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962405126 | NPPES |
| Florida | MEDICAID | 064147200 |
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