Individual provider · Type 1 NPI

Jennifer Moore, PA

Surgical Physician Assistant · Temple Terrace, FL

NPI number 1790781052 Active

Practice location

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925

Fax (813) 558-6187

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA3401 (FL)

Surgical Physician Assistant: Definition to come...

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About NPI 1790781052

Jennifer Moore, PA's National Provider Identifier is 1790781052, issued on Jun 22, 2005. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Temple Terrace, FL. The record was last updated on Mar 31, 2011.