Individual ProviderKurt W MoriRadiologyAllopathic & Osteopathic PhysiciansPractice Address3599 University Blvd S, Building 300, Jacksonville, FL 32216-4252(904) 399-5550PECOS EnrollmentThis provider is enrolled in PECOS as KURT MORI.Based on the most recent information from CMS, provider Kurt W Mori is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1821058157Provider TypeIndividualFull NameMori, Kurt WCredentialMDGenderMaleSole ProprietorNoEnumeration Date3/23/2006Last Updated8/22/2017Contact InformationPractice LocationPractice Address3599 University Blvd S, Building 300, Jacksonville, FL 32216-4252Phone(904) 399-5550Fax(904) 346-4334Mailing LocationMailing Address3599 University Blvd S, Building 300, Jacksonville, FL 32216-4252Phone(904) 399-5550Fax(904) 346-4334Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseME36779FloridaCode2085R0204XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseME36779FloridaProvider IdentifiersIDDescriptionIssuerID047706100DescriptionMedicaidIssuerUnlistedFloridaID00356243ADescriptionMedicaidIssuerUnlistedGeorgiaID15714DescriptionOtherIssuerBCBSFlorida