Ruben Antenor Moreno (NPI# 1225092331, PAC ID# 4789582123) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1225092331 |
| PAC ID by PECOS | 4789582123 |
| Professional Enrollment ID | I20110322000436 |
| Full Name | Ruben Antenor Moreno |
| Organization Legal Name | FLORIDA DERMATOLOGY ASSOCIATES INC |
| Address |
5070 Minton Rd Nw Suite 5 Palm Bay FL 32907-1157 |
| Phone Number | 3217681600 |
| Gender | M |
| Graduation Year | 1981 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 1557269982 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100019 | HOLMES REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 80 Woodland Ave, Cocoa Beach, FL 32931-2854 | 3217992840 | FLORIDA DERMATOLOGY ASSOCIATES INC |
| 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 | 3217681600 | FLORIDA DERMATOLOGY ASSOCIATES INC |
| Organization Legal Name | FLORIDA DERMATOLOGY ASSOCIATES INC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert M Taylor | Dermatology | Florida Dermatology Associates Inc | 80 Woodland Ave, Cocoa Beach, FL 32931-2854 |
| James M Magill | Pathology | Florida Dermatology Associates Inc | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 |
| Jeanette M Gluck | Physician Assistant | Florida Dermatology Associates Inc | 500 N Washington Ave, Suite 109, Titusville, FL 32796-2759 |
| Laura A Dijerome | Nurse Practitioner | Florida Dermatology Associates Inc | 500 N Washington Ave, Suite 109, Titusville, FL 32796-2759 |
| Marina Omarov | Physician Assistant | Florida Dermatology Associates Inc | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 |
| Anthony A Moreno | Physician Assistant | Florida Dermatology Associates Inc | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 |
| Frank G Lee | Dermatology | Florida Dermatology Associates Inc | 500 N Washington Ave, Suite 109, Titusville, FL 32796-2759 |
| Helen G Turk | Physician Assistant | Florida Dermatology Associates Inc | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 |
| Street Address |
5070 MINTON RD NW SUITE 5 |
| City | PALM BAY |
| State | FL |
| Zip | 32907-1157 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James M Magill | Pathology | Florida Dermatology Associates Inc | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 |
| Marina Omarov | Physician Assistant | Florida Dermatology Associates Inc | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 |
| Anthony A Moreno | Physician Assistant | Florida Dermatology Associates Inc | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 |
| Helen G Turk | Physician Assistant | Florida Dermatology Associates Inc | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashish R Udeshi | Anesthesiology | Tampa Pain Relief Center Inc | 490 Centre Lake Nedr, 200b, Palm Bay, FL 32907-1113 |
| Carlos Martinez Solis | Internal Medicine | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| Eric Vaughn Palmer | Nurse Practitioner | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| Harry W Carroll | Nurse Practitioner | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| Jennifer Dawn Logan | Nurse Practitioner | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| John W Rothwell Iii | Nurse Practitioner | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| Victor Cisneros | Nurse Practitioner | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| Howard Gershman | General Practice | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| Radoslaw J Czajkowski | Family Practice | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| Kerri L Connell | Physician Assistant | Medfast Urgent Care Centers LLC | 490 Ctr Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 |
| Find all physicians in zip 32907 | |||
| City | PALM BAY |
| Zip Code | 32907 |
| Specialty | DERMATOLOGY |
| City + Specialty | PALM BAY + DERMATOLOGY |
Please comment or provide details below to improve the information on Ruben Antenor Moreno.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.