Thomas J Moon Jr, MD | |
841 Prudential Dr Ste 280, Jacksonville, FL 32207-8350 | |
(904) 202-8550 | |
(904) 393-7808 |
Full Name | Thomas J Moon Jr |
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Gender | Male |
Speciality | Pediatrics - Pediatric Cardiology |
Location | 841 Prudential Dr Ste 280, Jacksonville, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982821799 | NPI | - | NPPES |
005915000 | Medicaid | FL | |
003125542A | Medicaid | GA | |
14KY8 | Other | FL | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0202X | Pediatrics - Pediatric Cardiology | DR47006 (Colorado) | Secondary |
2080P0202X | Pediatrics - Pediatric Cardiology | ME113107 (Florida) | Primary |
Entity Name | Baptist Specialty Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407226228 PECOS PAC ID: 3375597313 Enrollment ID: O20171220001665 |
Mailing Address | Practice Location Address |
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Thomas J Moon Jr, MD Po Box 746645, Atlanta, GA 30374-6645 Ph: (904) 202-2092 | Thomas J Moon Jr, MD 841 Prudential Dr Ste 280, Jacksonville, FL 32207-8350 Ph: (904) 202-8550 |
Dr. Maryam Ooja Abubakar, MD, MPH Pediatrics Medicare: Medicare Enrolled Practice Location: 655 W 8th St, Jacksonville, FL 32209 Phone: 904-244-3508 | |
Dr. Mohamad Alasad Tolaymat, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 820 Prudential Dr, Ufjp Pediatric Multi-specialty Clinic, Jacksonville, FL 32207 Phone: 904-633-0920 Fax: 904-633-0921 | |
Christopher Emanuel, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3945 San Jose Park Dr, Jacksonville, FL 32217 Phone: 904-731-3530 Fax: 904-737-1548 | |
Bridget Sharrar, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 12276 San Jose Blvd Ste 507, Jacksonville, FL 32223 Phone: 904-288-8910 Fax: 904-288-8912 | |
Kelly Marie Summers, ARNP Pediatrics Medicare: Medicare Enrolled Practice Location: 807 Childrens Way, Jacksonville, FL 32207 Phone: 904-697-3600 | |
Yekaterina Jones, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 841 Prudential Dr Ste 1130, Jacksonville, FL 32207 Phone: 904-633-4199 Fax: 904-633-4188 | |
Dr. Ronald P Carzoli Jr., MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1800 Barrs St, St Vincent's Medical Center, Jacksonville, FL 32204 Phone: 904-308-7994 |