Individual
DOUGLAS J MOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
(321) 434-1775
Mailing address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 434-1771
(321) 434-1775
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME45551
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040872700
—
FL
01
—
130014007
RR MEDICARE
FL
Enumeration date
11/14/2005
Last updated
07/31/2013
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