Individual
CORY ADAM MOOGERFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1100
Mailing address
17900 WAYSIDE BND, PUNTA GORDA, FL 33982-5056
(954) 579-6657
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9115334
FL
363AS0400X
Surgical Physician Assistant
9115334
FL
Other
Enumeration date
02/01/2022
Last updated
08/05/2022
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