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General NPI Number Information
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NPI Number | 1487974226
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Entity Type | Individual
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Provider Name | ROBIN MICHELLE MOORE MD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 07/05/2012
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Provider Practice Location Address
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Address Line | 1700 S 23RD ST LAWNWOOD REGIONAL MEDICAL CENTER
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City | FORT PIERCE
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State | FL
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Zip | 34950-4803
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Country | US
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Telephone | 772-468-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 610 CLEMATIS ST APT 705
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5324
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Country | US
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Telephone | 252-916-6798
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2010-00875
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 256744-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME111268
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License Number State | FL
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