Organization Name: | CHARLES H MOOREFIELD III MD PA |
NPI Number: | 1740402999 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES H MOOREFIELD (PRESIDENT) |
Mailing Address: | 701 E Michigan St Orlando |
State: | FL US |
Postal Code: | 328064623 |
Phone Number: | 4078438300 |
Fax Number: | 4078436103 |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 07/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0040364 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |