Individual
JESSICA MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, CSCS
Contact information
Practice address
5237 SW 40TH AVE, FORT LAUDERDALE, FL 33314-6501
(305) 298-7966
(954) 584-8190
Mailing address
5237 SW 40TH AVE, FORT LAUDERDALE, FL 33314-6501
(305) 298-7966
(954) 584-8190
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AL1012
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL1012
ATHLETIC TRAINER
FL
Enumeration date
01/05/2007
Last updated
07/08/2007
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