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Individual

DR. EDWIN A MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
6201 N SUNCOAST BLVD, CRYSTAL RIVER, FL 34428-6712
(800) 424-3672
(954) 377-3042
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS7951
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
260082000
FL
Enumeration date
07/05/2006
Last updated
10/22/2008
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