Organization
BRENDA K MOORE DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA KAY MOORE DO (PRESIDENT)
(832) 686-1965
Entity
Organization
Contact information
Practice address
1003 COLLEGE BLVD W, SUITE #2, NICEVILLE, FL 32578-1068
(850) 678-0443
Mailing address
1003 COLLEGE BLVD W, SUITE #2, NICEVILLE, FL 32578-1068
(850) 678-0443
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
OS 12957
FL
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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