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General NPI Number Information
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NPI Number | 1114035466
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Entity Type | Individual
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Provider Name | DR. JOSEPH G MOYSE
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Gender | Male
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 03/09/2025
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Provider Practice Location Address
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Address Line | 1502 LAKE TRAFFORD RD
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City | IMMOKALEE
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State | FL
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Zip | 34142-2618
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Country | US
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Telephone | 239-900-9170
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Fax | 561-878-8277
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Provider Business Mailing Address
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Address Line | 3155 LAKE WORTH RD STE 1
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City | PALM SPRINGS
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State | FL
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Zip | 33461-6917
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Country | US
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Telephone | 561-858-8817
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Fax | 561-878-8277
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 15224
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ACN252
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License Number State | FL
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