Organization
MEDICAL PSYCHIATRIC PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC MOORE MD (OWNER)
(407) 732-7957
Entity
Organization
Contact information
Practice address
3200 WATERFIELD DR, GARNER, NC 27529-7727
(407) 732-7957
Mailing address
4300 W LAKE MARY BLVD STE 1010-357, LAKE MARY, FL 32746-2060
(407) 732-7910
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
12/11/2023
Last updated
06/21/2024
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