Organization
MINIMALLY INVASIVE SURGERY INC
Active
Other names
Minimally Invasive Surgery Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD E MOORE JR. M.D. (SURGEON)
(954) 797-4220
Entity
Organization
Contact information
Practice address
4101 N.W. 4TH STREET, SUITE 401, PLANTATION, FL 33317-2813
(954) 797-4220
(954) 797-4221
Mailing address
4101 N.W. 4TH STREET, SUITE 401, PLANTATION, FL 33317-2813
(954) 797-4220
(954) 797-4221
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274253500
—
FL
01
—
71634
BCBS
FL
Enumeration date
03/14/2007
Last updated
07/21/2022
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