Individual
DR. JUSTIN R MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-4225
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-4225
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35.127204
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME155579
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094481
—
OH
05
—
122863800
—
FL
01
—
VI326
MEDICARE HF
FL
Enumeration date
07/23/2007
Last updated
06/03/2025
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