Individual
MS. DONNA RUTH MOORE-BOATWRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2762 DORA AVE, TAVARES, FL 32778-4970
(352) 742-7837
(352) 742-7837
Mailing address
2762 DORA AVE, TAVARES, FL 32778-4970
(352) 742-7837
(352) 742-7837
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
OT 10107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889168100
—
FL
Enumeration date
10/12/2006
Last updated
08/26/2008
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