Individual
ERIC A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
424 TIMBERWALK LN, LAKE MARY, FL 32746-4027
(407) 496-3549
(407) 878-4406
Mailing address
424 TIMBERWALK LN, LAKE MARY, FL 32746-4027
(407) 496-3549
(407) 878-4406
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME63176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617532012
CIGNA
FL
01
—
25666
BLUE CROSS BLUE SHIELD
FL
05
—
261403100
—
FL
01
—
3104492
AETNA HMO
FL
01
—
7726099
AETNA PPO/POS
FL
Enumeration date
07/12/2006
Last updated
11/01/2010
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