Individual
RONNIE LEE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3030 HARDEN BLVD, LAKELAND, FL 33803-7952
(863) 687-1222
(863) 603-6546
Mailing address
1324 LAKELAND HILLS BLVD, MANAGED CARE DEPT, LAKELAND, FL 33805
(863) 687-1100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9275253
FL
363LA2200X
Adult Health Nurse Practitioner
9275253
FL
363LG0600X
Gerontology Nurse Practitioner
9275253
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN9275253
FL
Other
Enumeration date
09/18/2018
Last updated
07/28/2022
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