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Organization
FLORIDA MEMORIAL UNIVERSITY
Active
Organization
FLORIDA MEMORIAL UNIVERSITY
Active
Other names
Florida Memorial Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (ADMINISTRATOR)
(972) 367-4845
Entity
Organization
Contact information
Practice address
15800 NW 42ND AVE, MIAMI GARDENS, FL 33054-6155
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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