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General NPI Number Information
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NPI Number | 1023050671
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Entity Type | Organization
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Legal Business Name | MATTHEW R MOORE MD PA
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 W CAMINO REAL SUITE 111
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City | BOCA RATON
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State | FL
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Zip | 33432-5966
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Country | US
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Telephone | 561-392-7435
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Fax | 561-392-7401
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Provider Business Mailing Address
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Address Line | 1793 SABAL PALM DR
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City | BOCA RATON
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State | FL
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Zip | 33432-7424
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Country | US
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Telephone | 561-392-7435
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Fax | 561-392-7401
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MATTHEW R MOORE
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Credential | M.D.
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Telephone | 561-392-7435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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