Individual
DAVID R MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 RIVERPLACE BLVD, SUITE: 620, JACKSONVILLE, FL 32207-9046
(904) 396-6620
(904) 396-6528
Mailing address
1200 RIVERPLACE BLVD, SUITE: 620, JACKSONVILLE, FL 32207-9046
(904) 396-6620
(904) 396-6528
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME0045122
FL
2084P0800X
Psychiatry Physician
Primary
ME45122
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164947
CIGNA
FL
05
—
260335700
—
FL
01
—
27356163700
OHIO BUREAU OF WORKERS COMPENSATION
OH
01
—
6609848
AETNA CHOICE POS
FL
01
—
694322
VALUE OPTIONS
FL
01
—
N614194
WELLCARE
FL
Enumeration date
04/29/2011
Last updated
03/04/2013
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