Provider Demographics
NPI:1538362553
Name:MOORE, HENRY PAUL (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:PAUL
Last Name:MOORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HENRY
Other - Middle Name:PAUL
Other - Last Name:MOORE-QUIROGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8137 MIZNER LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-1129
Mailing Address - Country:US
Mailing Address - Phone:954-394-9395
Mailing Address - Fax:
Practice Address - Street 1:1501 NW 9TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1407
Practice Address - Country:US
Practice Address - Phone:305-243-6732
Practice Address - Fax:305-243-3321
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2011-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 1060272084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology