Individual
BONNIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
38029 ARBOR RIDGE DR, ZEPHYRHILLS, FL 33540-1301
(813) 783-3811
(813) 788-1087
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(813) 780-1255
(813) 780-9773
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101875
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00078818
RR MEDICARE
FL
Enumeration date
07/02/2006
Last updated
01/04/2008
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