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General NPI Number Information
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NPI Number | 1699145375
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Entity Type | Individual
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Provider Name | JEFFREY C. MOORE DPT
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Gender | Male
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 2572 W STATE ROAD 426 STE 1080
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City | OVIEDO
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State | FL
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Zip | 32765-8300
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Country | US
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Telephone | 407-796-5265
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Fax | 407-796-5260
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Provider Business Mailing Address
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Address Line | 2572 W STATE ROAD 426 STE 1080
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City | OVIEDO
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State | FL
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Zip | 32765-8300
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Country | US
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Telephone | 407-796-5265
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Fax | 407-796-5260
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT30636
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT30636
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License Number State | FL
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