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General NPI Number Information
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NPI Number | 1790060754
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Entity Type | Individual
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Provider Name | JORDAN SETH MOSESON D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 8903 GLADES RD STE K1A
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City | BOCA RATON
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State | FL
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Zip | 33434-4010
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Country | US
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Telephone | 561-395-2626
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Fax | 561-955-6121
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Provider Business Mailing Address
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Address Line | 1001 NW 13TH ST STE 201
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City | BOCA RATON
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State | FL
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Zip | 33486-2269
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Country | US
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Telephone |
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | OS13426
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | OS13426
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License Number State | FL
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