Individual
JOHN CLIFTON MOORE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1033 N PARKWAY FRONTAGE RD, LAKELAND, FL 33803
(863) 647-8011
(863) 647-8029
Mailing address
PO BOX 95004, LAKELAND, FL 33804
(863) 680-7206
(863) 680-7420
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME27037
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066805200
—
FL
Enumeration date
02/08/2006
Last updated
02/16/2010
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