Individual
MR. DANIEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
680 2ND AVE N, SUITE 304, NAPLES, FL 34102-5753
(239) 261-7711
(239) 262-0176
Mailing address
6101 PINE RIDGE RD, NAPLES, FL 34119-3900
(239) 263-0849
(239) 263-2376
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101574
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970020475
MEDICARE RR
FL
01
—
Y00ZN
BCBS OF FL
FL
Enumeration date
06/28/2006
Last updated
10/27/2019
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