| Doctor Name: | REBECCA I. MOORHEAD |
| NPI Number: | 1144282195 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | ME62801 |
| Business Practice Address: | 100 Executive Way Suite 114 Ponte Vedra Beach, FL - 320822715 |
| Business Phone Number: | 9048917007 |
| Business Fax Number: | 9042803984 |
| Mailing Address: | 100 Executive Way, Suite 114 PONTE VEDRA BEACH |
| State: | FL |
| Postal Code: | 32082 |
| Phone Number: | 9048917007 |
| Fax Number: | 9042803984 |
| NPI Enumeration Date: | 04/05/2006 |
| NPI Last Update Date: | 04/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | ME62801 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |