Moore, Jennifer
Moore, Jennifer is an individual health care provider with primary practice located at 13020 N Telecom Pkwy , Temple Terrace FL 33637-0925. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Moore, Jennifer can be contacted via phone (813) 978-9700.Contact Information
Primary practice address
13020 N Telecom Pkwy
Temple Terrace FL 33637-0925
Phone: (813) 978-9700
Fax: (813) 558-6187
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA3401 | Florida |
Profile Details
| NPI number | 1790781052 |
|---|---|
| LBN Legal business name | Moore, Jennifer |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Mar 31st, 2011 - about 14 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 | 1790781052 | NPPES |
| Florida | MEDICAID | 290371700 | |
| Florida | Other | 970004474 |
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