Organization
TALLAHASSEE ANESTHESIOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MOORE M.D. (PRESIDENT)
(317) 567-2179
Entity
Organization
Contact information
Practice address
1300 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5054
(317) 567-2179
(317) 567-2191
Mailing address
11460 N MERIDIAN ST, #110, CARMEL, IN 46032-4408
(317) 567-2179
(317) 567-2191
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME6504
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259293200
—
FL
Enumeration date
07/22/2006
Last updated
10/05/2010
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