Individual
JUAN CARLOS MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
15302 N NEBRASKA AVE, TAMPA, FL 33613-1448
(813) 371-9020
(813) 971-2621
Mailing address
8408 SEVEN COVES CT, TAMPA, FL 33634-1041
(813) 492-9381
(813) 971-2621
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO7235
FL
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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