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General NPI Number Information
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NPI Number | 1558363952
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Entity Type | Individual
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Provider Name | JEFFREY GLENN MOSKOWITZ MD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 1000 W BROADWAY ST SUITE 206
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City | OVIEDO
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State | FL
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Zip | 32765-9260
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Country | US
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Telephone | 407-581-2888
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Fax | 407-992-7701
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Provider Business Mailing Address
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Address Line | 70 W GORE ST SUITE 200A
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City | ORLANDO
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State | FL
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Zip | 32806-1124
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Country | US
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Telephone | 407-581-2888
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Fax | 407-992-7701
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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 | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | ME79584
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License Number State | FL
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