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Individual

MRS. MARIANNE MOSELLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6652 GLEN MEADOW LOOP, LAKELAND, FL 33810-5881
(863) 255-7300
(863) 859-5350
Mailing address
6652 GLEN MEADOW LOOP, LAKELAND, FL 33810-5881
(863) 607-9611
(863) 859-5350

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
593286346
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
67-7735000
FL
Enumeration date
07/21/2008
Last updated
03/04/2025
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