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NPI Code Detail

MEDICARE: DR. JORDAN SETH MOSESON D.O.

MEDICARE:  DR. JORDAN SETH MOSESON  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery PhysicianOS13426FL
2208C00000XColon & Rectal Surgery PhysicianOS13426FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790060754
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORDAN SETH MOSESON D.O.
Provider Business Mailing Address
First Line : 1001 NW 13TH ST STE 201
Second Line :
City : BOCA RATON
State : FL
Zip : 33486-2269
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8903 GLADES RD STE K1A
Second Line :
City : BOCA RATON
State : FL
Zip : 33434-4010
Country : US
Telephone Number : 561-395-2626
Fax Number : 561-955-6121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2011
Last Update Date : 03/31/2025

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