Organization
INDEPENDENCE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL VINCENT MORO M.D. (PRESIDENT)
(757) 333-7625
Entity
Organization
Contact information
Practice address
813 INDEPENDENCE BLVD, SUITE A, VIRGINIA BEACH, VA 23455-6004
(757) 333-7625
(757) 333-7639
Mailing address
813 INDEPENDENCE BLVD, SUITE A, VIRGINIA BEACH, VA 23455-6004
(757) 333-7625
(757) 333-7639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101024391
VA
Other
Enumeration date
10/04/2006
Last updated
12/31/2009
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