Healthcare Provider Details

I. General information

NPI: 1831114586
Provider Name (Legal Business Name): MICHAEL WILLIAM MOSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL WILLIAM MOSER

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7540 W UNIVERSITY AVE
GAINESVILLE FL
32607-7609
US

IV. Provider business mailing address

5901 E FOWLER AVE STE 100
TEMPLE TERRACE FL
33617-2305
US

V. Phone/Fax

Practice location:
  • Phone: 352-647-9700
  • Fax: 352-273-7388
Mailing address:
  • Phone: 813-978-9700
  • Fax: 813-558-6185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME79550
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberME79550
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: