Organization
PA ASSOCIATES 'LLC.'
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY A. MOORE PA-C (PRESIDENT)
(321) 506-6781
Entity
Organization
Contact information
Practice address
110 ORLANDO BLVD, INDIALANTIC, FL 32903-3419
(321) 506-6781
Mailing address
PO BOX 847, ROSELAND, FL 32957-0847
(321) 506-6781
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9104697
FL
Other
Enumeration date
08/26/2010
Last updated
12/22/2011
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