Healthcare Provider Details

I. General information

NPI: 1740418078
Provider Name (Legal Business Name): CARRIE MOSELEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6938 MEDICAL VIEW LN
ZEPHYRHILLS FL
33542
US

IV. Provider business mailing address

6938 MEDICAL VIEW LN
ZEPHYRHILLS FL
33542-6602
US

V. Phone/Fax

Practice location:
  • Phone: 813-780-2550
  • Fax:
Mailing address:
  • Phone: 813-780-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number68682
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: