Roger Allan Mosure, ATC ETT LAT
Legal Medicine in Lake Mary, FL. Individual provider (NPI-1).
NPI number1790742484
StatusActive
Last updated in NPPESJul 13, 2026
Details
- NPI
- 1790742484
- Entity type
- Individual (NPI-1)
- Name
- Roger Allan Mosure
- Credential
- ATC ETT LAT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 27, 2006
- Last updated
- Jul 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 173000000X | Legal Medicine | 00-170 | FL | Yes |
Practice location
6551longwood-Lake Mary BlvdLake Mary, FL 32746
Phone 407-320-9550
Mailing address
546 Tiberon Cove RdLongwood, FL 32750-2951
Phone 407-332-6184
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