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Individual

DR. SERGIO G MOREIRA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
320 RACETRACK RD NW STE 100C, FORT WALTON BEACH, FL 32547-1796
(850) 863-3463
(850) 862-0188
Mailing address
320 RACETRACK RD NW STE 100C, FORT WALTON BEACH, FL 32547-1796
(850) 863-3463
(850) 862-0188

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
M8184
TX
208800000X
Urology Physician
Primary
ME89888
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117574300
FL
01
T7744
MEDICARE HF
FL
Enumeration date
05/10/2006
Last updated
12/23/2024
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