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Individual

KELLY MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3919 RIGA BLVD, TAMPA, FL 33619-1345
(813) 558-9500
Mailing address
101 S BAYSHORE BLVD STE 43, SAFETY HARBOR, FL 34695-4028
(812) 887-3738

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9351074
FL

Other

Enumeration date
01/25/2011
Last updated
12/05/2022
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