Individual
MELISSA ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 821-8038
Mailing address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME150766
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111071300
—
FL
01
—
I07FM
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/01/2016
Last updated
07/22/2022
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