Individual
JODY LEE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3525 LAKELAND HILLS BLVD, LAKELAND, FL 33805-1965
(863) 603-6565
Mailing address
3991 BRUTON RD, PLANT CITY, FL 33565-7023
(813) 716-9698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9329228
FL
363LF0000X
Family Nurse Practitioner
ARNP9329228
FL
Other
Enumeration date
05/06/2016
Last updated
02/18/2025
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