Individual
CHRISTOPHER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1715 VILLAGE WAY, ORANGE PARK, FL 32073-5263
(904) 264-8418
Mailing address
1715 VILLAGE WAY, ORANGE PARK, FL 32073-5263
(904) 264-8418
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME96662
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AH583Z
PTAN
FL
Enumeration date
10/17/2006
Last updated
09/09/2009
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