Individual
ERIN M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
836 PRUDENTIAL DR, STE 1804, JACKSONVILLE, FL 32207
(904) 398-3888
(904) 400-6675
Mailing address
1824 KING ST, STE 200, JACKSONVILLE, FL 32204-4735
(904) 384-3343
(904) 400-6671
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME101863
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000999700
—
FL
05
—
167164085A
—
GA
01
—
P00718847
MEDICARE RAILROAD
—
Enumeration date
08/01/2005
Last updated
11/23/2022
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