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General NPI Number Information
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NPI Number | 1598958571
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Entity Type | Organization
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Legal Business Name | ROBERT W MOSCA DO PA
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 807 STATE ROAD 44
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-7271
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Country | US
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Telephone | 386-428-5554
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Fax | 386-409-7971
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Provider Business Mailing Address
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Address Line | 807 STATE ROAD 44
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-7271
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Country | US
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Telephone | 386-428-5554
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Fax | 386-409-7971
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARGARET M SAMANO
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Credential |
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Telephone | 386-428-5554
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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 | OS8981
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License Number State | FL
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