Moreno, Raul J
Moreno, Raul J is an individual health care provider with primary practice located at 2639 Oak St , Jacksonville FL 32204-4505. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Moreno, Raul J can be contacted via phone (904) 387-5600.Contact Information
Primary practice address
2639 Oak St
Jacksonville FL 32204-4505
Phone: (904) 387-5600
Fax: (904) 388-0114
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 34670 | Georgia |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 34670 | Georgia |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | ME59679 | Florida |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | ME0059679 | Florida |
Profile Details
| NPI number | 1932109659 |
|---|---|
| LBN Legal business name | Moreno, Raul J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 22nd, 2005 |
| Last updated | Apr 20th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932109659 | NPPES |
| Georgia | MEDICAID | 000464065A | |
| Georgia | MEDICAID | 056043000 |
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