| Doctor Name: | MRS. VIRGINIA GAIL MOORE |
| NPI Number: | 1164528816 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP 9275839 |
| Business Practice Address: | 10000 Bay Pines Blvd Bay Pines, FL - 337448200 |
| Business Phone Number: | 7273986661 |
| Business Fax Number: | |
| Mailing Address: | 7305 N Military Trl, RIVIERA BEACH |
| State: | FL |
| Postal Code: | 334107417 |
| Phone Number: | 5615573936 |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2006 |
| NPI Last Update Date: | 12/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | ARNP 9275839 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |