Individual
MRS. JUDITH MAE MOOREHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15375 SE 156TH PLACE RD, WEIRSDALE, FL 32195-2218
(352) 821-4082
Mailing address
15375 SE 156TH PLACE RD, WEIRSDALE, FL 32195-2218
(352) 821-4082
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230291800
—
FL
Enumeration date
04/28/2008
Last updated
04/28/2008
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