Organization
THORVASC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOSES DESMOND DEGRAFT-JOHNSON MD (OWNER)
(305) 301-8283
Entity
Organization
Contact information
Practice address
2623 CENTENNIAL BLVD, SUITE 102, TALLAHASSEE, FL 32308-0585
(850) 792-4722
(850) 792-4727
Mailing address
400 CAPITAL CIR SE, STE 18148, TALLAHASSEE, FL 32301-3802
(850) 792-4722
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
01/29/2015
Last updated
05/18/2017
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