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NPI Code Detail

MEDICARE: MOORE AND HEALEY, PA

MEDICARE: MOORE AND HEALEY, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistME0027744FL

General Provider Information

NPI Number : 1669667390
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOORE AND HEALEY, PA
Provider Business Mailing Address
First Line : 4910 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-4817
Country : US
Telephone Number : 904-399-0667
Fax Number : 904-399-3330
Provider Business Practice Location Address
First Line : 4910 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-4817
Country : US
Telephone Number : 904-399-0667
Fax Number : 904-399-3330
Authorized Official
Title or Position : OFFICE MANAGER
Name : MS. CAROL R BLACK
Credential :
Telephone Number : 904-399-0667
Provider Enumeration Date : 09/06/2007
Last Update Date : 12/16/2010

Similar Medicare Providers

1568423622 — DR. FRANCIS A CHRZANOWSKI JR. MD
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1740241496 — DR. ROBERT CLARENCE MOORE M.D.
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1801857412 — DR. FRANK HENRY HEALEY III MD
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Directions to “MOORE AND HEALEY, PA ” Practice Location

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