Individual
DR. JASON ALAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2402 FRIST BLVD, STE. 204, FORT PIERCE, FL 34950-4838
(772) 462-3939
Mailing address
2402 FRIST BLVD STE 204, FORT PIERCE, FL 34950-4838
(772) 462-3939
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
ME113898
FL
2086S0127X
Trauma Surgery Physician
ME113898
FL
Other
Enumeration date
01/27/2009
Last updated
01/28/2022
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