Individual
DR. MARK JEFFREY MOGUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
92 W MILLER ST, ORLANDO, FL 32806-2032
(218) 418-5883
(321) 841-8560
Mailing address
92 W MILLER ST, ORLANDO, FL 32806-2032
(218) 418-5883
(321) 841-8560
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G068539
CA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
ME121139
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111952500
—
FL
Enumeration date
02/14/2006
Last updated
06/02/2025
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