Moore, Keith R

Moore, Keith R is an individual health care provider with primary practice located at 10800 Dylan Loren Cir Suite 102, Orlando FL 32825-4437. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Moore, Keith R can be contacted via phone (407) 277-8665.

Contact Information

Primary practice address
10800 Dylan Loren Cir Suite 102 Orlando FL 32825-4437
Phone: (407) 277-8665
Fax: (407) 277-1267
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X OS6231 Florida

Profile Details

NPI number 1760471304
LBN Legal business name Moore, Keith R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Jul 6th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760471304 NPPES
Florida MEDICAID 003311800

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