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General NPI Number Information
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NPI Number | 1376518142
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Entity Type | Individual
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Provider Name | RICHARD B MOORE MD PA
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 3450 11TH CT # 104A
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City | VERO BEACH
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State | FL
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Zip | 32960-5012
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Country | US
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Telephone | 772-226-4830
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 VON PHISTER ST
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City | KEY WEST
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State | FL
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Zip | 33040-4830
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Country | US
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Telephone | 772-713-1256
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0048243
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101275204
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME0048243
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101275204
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License Number State | VA
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