Healthcare Provider Details

I. General information

NPI: 1285260141
Provider Name (Legal Business Name): AVA VOSS MOFFETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AVA KATARINA VOSS MD

II. Dates (important events)

Enumeration Date: 03/22/2020
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 S BLAIR STONE RD APT 234
TALLAHASSEE FL
32301-6988
US

IV. Provider business mailing address

3501 S BLAIR STONE RD APT 234
TALLAHASSEE FL
32301-6988
US

V. Phone/Fax

Practice location:
  • Phone: 770-401-6338
  • Fax:
Mailing address:
  • Phone: 770-401-6338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME173386
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: