Healthcare Provider Details

I. General information

NPI: 1194764613
Provider Name (Legal Business Name): M. LOUIS MOY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MEREDITH LOUIS MOY MD

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1197
US

IV. Provider business mailing address

PO BOX 918025
ORLANDO FL
32891-8025
US

V. Phone/Fax

Practice location:
  • Phone: 352-548-6000
  • Fax:
Mailing address:
  • Phone: 352-273-6815
  • Fax: 352-392-8846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD068676L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME105105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: