Independence Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101024391 Issued in VA

Legal business name

INDEPENDENCE FAMILY MEDICINE

Practice address

813 Independence Blvd
Suite a
Virginia Beach, VA 23455-6004

Phone

(757) 333-7625

Fax

(757) 333-7639

NPI assigned

Oct 4, 2006

Last updated

Dec 31, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Vincent Moro, M.D.

Title

President

Phone

(757) 333-7625

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1770678450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 INDEPENDENCE BLVD",
            "address_2": "SUITE A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556004",
            "telephone_number": "757-333-7625",
            "fax_number": "757-333-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 INDEPENDENCE BLVD",
            "address_2": "SUITE A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556004",
            "telephone_number": "757-333-7625",
            "fax_number": "757-333-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "MORO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-333-7625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101024391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.