Marilyn C. Moss, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME22466 Issued in FL

Legal business name

MARILYN C. MOSS, M.D.

Practice address

3210 N Wickham Rd
Suite 1
Melbourne, FL 32935-2300

Phone

(321) 752-7100

Fax

(321) 752-7105

NPI assigned

Mar 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marilyn Carol Moss, MD

Title

Physician and Owner

Phone

(321) 752-7100

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801914858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 N WICKHAM RD",
            "address_2": "SUITE 1",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352300",
            "telephone_number": "321-752-7100",
            "fax_number": "321-752-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 N WICKHAM RD",
            "address_2": "SUITE 1",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352300",
            "telephone_number": "321-752-7100",
            "fax_number": "321-752-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILYN C. MOSS, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "PHYSICIAN AND OWNER",
        "authorized_official_telephone_number": "321-752-7100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME22466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.