Moon, Thomas J

Moon, Thomas J is an sole proprietor health care provider with primary practice located at 841 Prudential Dr Ste 280 , Jacksonville FL 32207-8350. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Cardiology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pediatric Cardiology is his primary health care specialty. Moon, Thomas J can be contacted via phone (904) 202-8550.

Contact Information

Primary practice address
841 Prudential Dr Ste 280 Jacksonville FL 32207-8350
Phone: (904) 202-8550
Fax: (904) 393-7808
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X DR47006 Colorado
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X ME113107 Florida

Profile Details

NPI number 1982821799
LBN Legal business name Moon, Thomas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 20th, 2007
Last updated May 11th, 2023 - about last year

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1982821799 NPPES
Georgia MEDICAID 003125542A
Georgia Other 14KY8
Georgia MEDICAID 005915000

Popular Providers