Individual
DR. FREDERICK A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.S.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-5670
(352) 273-5683
Mailing address
PO BOX 918025, ORLANDO, FL 32891-0001
(352) 273-5670
(352) 273-5683
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
F9847
TX
2086S0102X
Surgical Critical Care Physician
Primary
ME110310
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003839400
—
FL
05
—
136971210
—
TX
01
—
136971211
CSHCN
TX
01
—
8V8609
BLUE CROSS BLUE SHIELD
TX
01
—
P00345039
RAILROAD MEDICARE
TX
Enumeration date
06/03/2006
Last updated
08/31/2011
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