OMAR JISHI MOORE (NPI# 1487072245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487072245 |
| Entity Type | Individual |
| Full Name | OMAR JISHI MOORE |
| Credential | M.D. |
| Practice Address |
841 Prudential Dr Fl 10 Jacksonville FL 32207-8329 |
| Mailing Address |
Po Box 41113 Jacksonville FL 32203-1113 |
| Practice Telephone | 9043985404 |
| Practice Fax Number | 9043915545 |
| Mailing Telephone | 9043764400 |
| Mailing Fax Number | 9043915595 |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2019-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
ME134726 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
841 PRUDENTIAL DR FL 10 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215906649 | Baptist Behavioral Health, LLC | Counselor | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2006-03-17 |
| 1669015111 | Miguel A Franco | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2019-10-28 |
| 1477103539 | Adeline Leon | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2019-09-19 |
| 1023537602 | Janette Thames | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2017-09-14 |
| 1275931339 | Henry Benson | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2014-12-05 |
| 1780008425 | Daniel Howard Olsen | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2014-02-18 |
| 1255694667 | Scott M Dellorso | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2012-06-20 |
| 1083846414 | Karen Cooper Sandbach | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2009-08-18 |
| 1427205038 | Jason Shaun Day | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Credentialing Department, Jacksonville, FL 32207-8329 | 2008-08-26 |
| 1528229184 | Georgia Gianakakos | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Credentialing Department, Jacksonville, FL 32207-8329 | 2008-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285138495 | Yulia Salamatova | Psychiatry & Neurology | 580 W 8th St # T17, Jacksonville, FL 32209-6533 | 2018-03-21 |
| 1619471018 | William Joseph Scharpf | Psychiatry & Neurology | 653-1 West 8th Street, L18, 4th Floor, Lrc, Jacksonville, FL 32209 | 2018-03-20 |
| 1184155616 | Kyle Wuthrich | Psychiatry & Neurology | 580 W 8th St Fl 9, Jacksonville, FL 32209-6533 | 2017-03-26 |
| 1932511235 | Shannon Laboy | Psychiatry & Neurology | 580 W 8th St # T1-9t17, Jacksonville, FL 32209-6533 | 2014-05-21 |
| 1174933147 | Caitlin E D'souza | Psychiatry & Neurology | 14540 Old Saint Augustine Rd Ste 216, Jacksonville, FL 32258-7418 | 2014-04-30 |
| 1235416322 | Benjamin E Moore Md Pa | Psychiatry & Neurology | 2 Shircliff Way Ste 925, Jacksonville, FL 32204-4711 | 2011-11-03 |
| 1598995599 | Baptist Neurology Inc | Psychiatry & Neurology | 3563 Phillips Hwy Ste 106a, Jacksonville, FL 32207-5663 | 2009-07-24 |
| 1316104722 | Candice Waked Riggeal | Psychiatry & Neurology | 841 Prudential Dr 10th Floor, Jacksonville, FL 32207-8329 | 2008-05-22 |
| 1508089194 | James Gordon Creveling Jr | Psychiatry & Neurology | 7842 Monterey Bay Dr, Jacksonville, FL 32256-2936 | 2007-04-11 |
| 1053471987 | Mark K Emas | Psychiatry & Neurology | 4085 University Blvd South, # 3, Jacksonville, FL 32216 | 2006-12-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.