Individual
ANTHONY ALLEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4215 EDGEWATER DR, ORLANDO, FL 32804-2206
(855) 582-7747
(888) 972-4761
Mailing address
695 US HIGHWAY 46, STE 400A, FAIRFIELD, NJ 07004-1568
(973) 894-1265
(888) 972-6480
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAT9104697
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BJ031X
QSS SCS PTAN
FL
Enumeration date
08/14/2008
Last updated
07/21/2022
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