Provider Demographics
NPI:1730989781
Name:MOSER, ROXIE NOEL
Entity type:Individual
Prefix:
First Name:ROXIE
Middle Name:NOEL
Last Name:MOSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROXIE
Other - Middle Name:NOEL
Other - Last Name:MOSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10909 LEEDS RD
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-2673
Mailing Address - Country:US
Mailing Address - Phone:727-222-7421
Mailing Address - Fax:
Practice Address - Street 1:10909 LEEDS RD
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-2673
Practice Address - Country:US
Practice Address - Phone:727-222-7421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM-260-734-93-640-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health