Provider Demographics
NPI:1588918171
Name:MOSS, PAULA P (AP)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:P
Last Name:MOSS
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 DALEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1844
Mailing Address - Country:US
Mailing Address - Phone:561-703-8030
Mailing Address - Fax:
Practice Address - Street 1:5055 DALEWOOD LN
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-1844
Practice Address - Country:US
Practice Address - Phone:561-703-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-03
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3187171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist