Individual
CHARLES HARRELSON MOSS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
1825 HURLBURT RD STE 14, FORT WALTON BEACH, FL 32547-3737
(850) 610-8820
(844) 297-8690
Mailing address
4440 FRUITVILLE RD, SARASOTA, FL 34232-1926
(941) 366-0134
(941) 404-1760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-104360
AL
Other
Enumeration date
08/25/2008
Last updated
06/25/2019
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