Organization
LIVE WELL M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX MOORE M.D. (DOCTOR)
(904) 807-9747
Entity
Organization
Contact information
Practice address
11512 LAKE MEAD AVE, BUILDING 521, JACKSONVILLE, FL 32256-9680
(904) 807-9747
(904) 807-9746
Mailing address
11512 LAKE MEAD AVE, BUILDING 521, JACKSONVILLE, FL 32256-9680
(904) 807-9747
(904) 807-9746
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
08/04/2010
Last updated
08/04/2010
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