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NPI Code Detail

MEDICARE: DR. CLAIRE FIELDING MOORE O.D.

MEDICARE: DR. CLAIRE FIELDING MOORE O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2664OK

General Provider Information

NPI Number : 1891005542
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLAIRE FIELDING MOORE O.D.
Provider Business Mailing Address
First Line : 1346 GILFORD POINT LN
Second Line :
City : CHAMPIONS GATE
State : FL
Zip : 33896-5300
Country : US
Telephone Number : 918-306-0980
Fax Number :
Provider Business Practice Location Address
First Line : 1346 GILFORD POINT LN
Second Line :
City : CHAMPIONS GATE
State : FL
Zip : 33896-5300
Country : US
Telephone Number : 918-306-0980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2010
Last Update Date : 10/15/2010

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