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Individual

ROGER ALLAN MOSURE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
ATC ETT LAT

Contact information

Practice address
6551LONGWOOD-LAKE MARY BLVD, LAKE MARY, FL 32746
(407) 320-9550
Mailing address
546 TIBERON COVE RD, LONGWOOD, FL 32750-2951
(407) 332-6184

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
00-170
FL

Other

Enumeration date
04/27/2006
Last updated
07/08/2007
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