Keeley, Katherine Moore

Keeley, Katherine Moore is an individual health care provider with primary practice located at 8430 Enterprise Cir Suite 130, Lakewood Ranch FL 34202-4107. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Adolescent Medicine is her primary health care specialty. Keeley, Katherine Moore can be contacted via phone (941) 366-3000.

Contact Information

Primary practice address
8430 Enterprise Cir Suite 130 Lakewood Ranch FL 34202-4107
Phone: (941) 366-3000
Fax: (941) 366-3002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME57672 Florida
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X ME57672 Florida

Profile Details

NPI number 1073548210
LBN Legal business name Keeley, Katherine Moore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Sep 2nd, 2015 - about 10 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 1073548210 NPPES
Florida Other 33181 BCBS FLORIDA
Florida Other 11280 BCBS FLORIDA
Florida Other 622723 BCBS FLORIDA
Florida MEDICAID 058451700 BCBS FLORIDA

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