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Individual

MR. ISMAEL MORENO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
513 FEATHER TREE DR, CLEARWATER, FL 33765-2456
(727) 422-5003
Mailing address
513 FEATHER TREE DR, CLEARWATER, FL 33765-2456
(727) 422-5003

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
9255074
FL

Other

Enumeration date
11/16/2009
Last updated
11/16/2009
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