Individual
BRIAN FERNANDO MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0111
Mailing address
PO BOX 100277, GAINESVILLE, FL 32610-0277
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
161522
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2020
Last updated
06/11/2023
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