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Individual
SEAN JOSEPH MOORE
Active
Individual
SEAN JOSEPH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110480
FL
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021656300
—
FL
Enumeration date
07/11/2017
Last updated
10/04/2017
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