Individual
ASHLEE E. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901
(321) 434-1401
(321) 434-1667
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1401
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
57407
WI
208600000X
Surgery Physician
35.093515
OH
208600000X
Surgery Physician
57407
WI
2086S0127X
Trauma Surgery Physician
Primary
ME118118
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010462400
—
FL
01
—
HR712X
HFMG FL MEDICARE
FL
01
—
HR712Y
FL MEDICARE
FL
Enumeration date
03/30/2007
Last updated
05/25/2021
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