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Individual

DR. RUBEN ANTENOR MORENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5070 MINTON RD NW, SUITE 5, PALM BAY, FL 32907-1157
(321) 768-1600
Mailing address
5070 MINTON RD NW, SUITE 3A, PALM BAY, FL 32907-1157
(321) 768-1600

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME51282
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0561133
CIGNA
FL
01
05683
BCBS
FL
01
20015
FLORIDIANCARE
FL
01
4112056
AETNA
FL
01
592896023
UNITEDHEALTHCARE
FL
Enumeration date
04/14/2006
Last updated
11/12/2020
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