Individual
KEITH R MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10800 DYLAN LOREN CIR, SUITE 102, ORLANDO, FL 32825-4437
(407) 277-8665
(407) 277-1267
Mailing address
9500 S DADELAND BLVD, STE 200, MIAMI, FL 33156-2866
(786) 530-3820
(305) 675-3378
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
OS6231
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003311800
—
FL
Enumeration date
10/17/2005
Last updated
07/06/2022
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