Individual
MS. BONNIE SUE MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4301 N HABANA AVE, TAMPA, FL 33607-6546
(813) 870-4064
(813) 443-8146
Mailing address
PO BOX 10744, CLEARWATER, FL 33757-8744
(727) 532-0002
(727) 266-4943
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9289331
FL
363L00000X
Nurse Practitioner
Primary
RN9289331
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010919700
—
FL
Enumeration date
01/09/2014
Last updated
12/19/2016
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