Organization
BENJAMIN E MOORE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN E MOORE MD (OWNER)
(904) 387-6116
Entity
Organization
Contact information
Practice address
2 SHIRCLIFF WAY STE 925, JACKSONVILLE, FL 32204-4711
(904) 387-6116
(904) 387-6118
Mailing address
PO BOX 17809, JACKSONVILLE, FL 32245-7809
(904) 723-5665
(904) 338-0951
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME39355
FL
Other
Enumeration date
11/03/2011
Last updated
01/09/2012
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