Individual
THOMAS J MOON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 627-9350
(352) 273-9054
Mailing address
PO BOX 746645, ATLANTA, GA 30374-6645
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME113107
FL
2080P0202X
Pediatric Cardiology Physician
DR47006
CO
2080P0202X
Pediatric Cardiology Physician
Primary
ME113107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125542A
—
GA
05
—
005915000
—
FL
01
—
14KY8
BCBS
FL
Enumeration date
04/20/2007
Last updated
04/28/2026
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