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Dr. Luis Antonio Moreno, MD
General Practice Physician in Edgewater, Florida
NPI 1538372958

Luis Antonio Moreno is a General Practice Physician based in Titusville, FL. Luis Antonio Moreno practices in Edgewater, FL and has the professional credentials of MD. The NPI Number for Luis Antonio Moreno is 1538372958 and holds a License No. ME 88233 (Florida).

The current practice location address for Luis Antonio Moreno is 2984 S Ridgewood Ave Ste 1, Edgewater, FL and can be reached out via phone at 386-428-4640 and via fax at 386-426-1409.

Location: 2984 S Ridgewood Ave Ste 1, Edgewater, FL, 32796-2265
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538372958
Provider Name
Luis Antonio Moreno
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2984 S Ridgewood Ave Ste 1, Edgewater, FL, 32796-2265
Phone Number
386-428-4640
Fax Number
386-426-1409
Provider Enumeration Date
05/08/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2984 S Ridgewood Ave Ste 1
City
Edgewater
State
Florida
Zip
32141-7515
Phone Number
386-428-4640
Fax Number
386-426-1409
person
Provider Business Mailing Address Details
Address
2984 S Ridgewood Ave Ste 1
City
Edgewater
State
Florida
Zip
32141-7515
Phone Number
386-428-4640
Fax Number
386-426-1409
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
ME88233 (Florida)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
ME 88233 (Florida)
Definition
Definition to come...
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