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General NPI Number Information
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NPI Number | 1093750333
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Entity Type | Individual
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Provider Name | BEVERLY ALMOJERA MOSSMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/12/2009
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Provider Practice Location Address
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Address Line | 5601 TIMUQUANA RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-8054
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Country | US
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Telephone | 904-771-5910
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Fax | 904-771-1401
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Provider Business Mailing Address
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Address Line | 5601 TIMUQUANA RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-8054
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Country | US
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Telephone | 904-771-5910
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Fax | 904-771-1401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME105289
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License Number State | FL
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