Organization
MOORINGS PARK HEALTHY LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MORTON (CHIEF COMPLIANCE OFFICER)
(239) 643-9168
Entity
Organization
Contact information
Practice address
120 MOORINGS PARK DR, NAPLES, FL 34105-2122
(239) 430-6387
(239) 430-6365
Mailing address
120 MOORINGS PARK DR, NAPLES, FL 34105-2122
(239) 430-6387
(239) 430-6365
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FX839A
PTAN
FL
Enumeration date
12/20/2011
Last updated
09/09/2014
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