Provider Demographics
NPI:1245425982
Name:MOORE, JAY WINSTON (PHD, FACMG)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:WINSTON
Last Name:MOORE
Suffix:
Gender:M
Credentials:PHD, FACMG
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Mailing Address - Street 1:10421 UNIVERSITY CENTER DR
Mailing Address - Street 2:STE. 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-6427
Mailing Address - Country:US
Mailing Address - Phone:813-615-4362
Mailing Address - Fax:813-972-4632
Practice Address - Street 1:10421 UNIVERSITY CENTER DR
Practice Address - Street 2:STE. 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-6427
Practice Address - Country:US
Practice Address - Phone:813-615-4362
Practice Address - Fax:813-972-4632
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDI38149207SC0300X
NYMOORJ1207SC0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SC0300XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Cytogenetics