Individual
DR. RAUL J MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2639 OAK ST, JACKSONVILLE, FL 32204-4505
(904) 387-5600
(904) 388-0114
Mailing address
8786 PERIMETER PARK BLVD, JACKSONVILLE, FL 32216-6347
(904) 997-9202
(904) 996-1446
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
34670
GA
207W00000X
Ophthalmology Physician
Primary
ME0059679
FL
207WX0107X
Retina Specialist (Ophthalmology) Physician
34670
GA
207WX0107X
Retina Specialist (Ophthalmology) Physician
ME59679
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000464065A
—
GA
05
—
056043000
—
FL
Enumeration date
07/22/2005
Last updated
04/20/2023
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