Organization
DUAL HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE MOORE PMHNP-BC, AGNP-C, NP (CEO)
(863) 669-5654
Entity
Organization
Contact information
Practice address
815 W 6TH ST, LAKELAND, FL 33805-4200
(863) 640-8161
Mailing address
815 W 6TH ST, LAKELAND, FL 33805-4200
(863) 640-8161
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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