Individual
MR. JAMES MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
310 AMBERJACK PL, MELBOURNE BEACH, FL 32951-2906
(321) 684-1193
Mailing address
PO BOX 510764, MELBOURNE BEACH, FL 32951-0764
(321) 684-1193
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9103288
FL
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003500000
—
FL
Enumeration date
10/31/2005
Last updated
07/21/2022
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