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Individual

DR. MARSHALL NORMAN MOSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1644 NE 164TH ST, NORTH MIAMI BEACH, FL 33162-4017
(305) 940-2065
(305) 940-2065
Mailing address
1025 NE 172ND TER, MIAMI, FL 33162-2639
(305) 654-1121
(305) 940-2065

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC1170
FL
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPC1170
FL
152WL0500X
Low Vision Rehabilitation Optometrist
OPC1170
FL
152WS0006X
Sports Vision Optometrist
OPC1170
FL
152WV0400X
Vision Therapy Optometrist
OPC1170
FL
152WX0102X
Occupational Vision Optometrist
OPC1170
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
084858100
FL
Enumeration date
07/20/2006
Last updated
03/21/2012
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