JASON ANTHONY MOORE PA-C NPI 1902325681

NPI Information

NPI: 1902325681
Provider Name: JASON ANTHONY MOORE, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
13861 PLANTATION RD STE 104
FORT MYERS, FL
ZIP 33912
Phone: (239) 225-1306
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Jason Anthony Moore, PA-C is a medical physician assistant in Fort Myers, FL. Jason Anthony Moore, PA-C NPI is 1902325681. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

13861 PLANTATION RD STE 104
FORT MYERS, FL
ZIP 33912-342
Phone: (239) 225-1306
Fax: (239) 768-1313

The NPI 1902325681 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/14/2017 and was last updated on 9/14/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PAT9110628	FLORIDA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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