# JEFFREY M MOORE OD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568537454
- **Authorized official:** DR. JEFFREY M MOORE OD (OWNER OPTOMETRIST)
- **Authorized official phone:** (941) 255-0588

## Contact information

- **Practice address:** 1444 TAMIAMI TRAIL, 481, PT CHARLOTTE, FL 33948
- **Practice address phone:** (941) 255-0588
- **Mailing address:** 5142 SW 3RD AVE, CAPE CORAL, FL 33914-7119
- **Mailing address phone:** (239) 549-2506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC1680 | FL | Yes |

## Other

- **Enumeration date:** 11/24/2006
- **Last updated:** 01/12/2009