Healthcare Provider Details

I. General information

NPI: 1467823971
Provider Name (Legal Business Name): WILLIAM DANIEL MOSQUERA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14340 LAYHILL RD
SILVER SPRING MD
20906-1909
US

IV. Provider business mailing address

14340 LAYHILL RD
SILVER SPRING MD
20906-1909
US

V. Phone/Fax

Practice location:
  • Phone: 301-986-9100
  • Fax: 301-986-9101
Mailing address:
  • Phone: 301-438-3475
  • Fax: 301-438-6948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA4331
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number30180
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: