PA ASSOCIATES 'LLC.'
Nursing at Orlando Blvd, Melbourne, FL

License number
Florida PA9104697
Category
Nursing
Type
Surgical
Owner
Name: MR. ANTHONY A. MOORE PA-C
Title: PRESIDENT
Phone: (321) 506-6781
Address
Address 2
110 Orlando Blvd, Melbourne, FL 32903
PO Box 847, Roseland, FL 32957
National Provider ID: 1891001939
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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P.A. ASSOCIATES "LLC."

Melbourne, FL  -  Roseland, FL

Industry:
Nonclassifiable Establishments
Registration:
Jul 1, 2010
Addresses:
110 Orlando Blvd, Indialantic, FL 32903 (Physical)
Roseland, FL 32957 (Mailing)
4975 Dixie Hwy NE, Melbourne, FL 32905
1920 Elizabeth St, Melbourne, FL 32901
PO Box 847, Roseland, FL 32957
State ID:
L10000070380
Business type:
Florida Limited Liability Company
Managing Members:
Anthony Ap.a.-C Moore (Manager), 110 Orlando Blvd, Indialantic, FL 32903 (Physical),Phd Domkowski, 13837 Us Hwy 1, Sebastian, FL 32958 (Physical),Patrick W. Domkowski (Managing Member),...
Agent:
Anthony Moore,110 Orlando Blvd, Indialantic, FL 32903 (Physical)
EIN:
27-3041274

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