Individual
R. LAWRENCE MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3600
(904) 697-3927
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4236
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
35070198
OH
2086S0120X
Pediatric Surgery Physician
Primary
ME140171
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3101057
—
OH
Enumeration date
11/22/2005
Last updated
03/07/2023
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