Individual
MARSHA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
284 WILMERS RD, PUNTA GORDA, FL 33982-8570
(941) 621-4841
Mailing address
284 WILMERS RD, PUNTA GORDA, FL 33982-8570
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906957
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20904383
FB
FL
Enumeration date
08/02/2018
Last updated
08/02/2018
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