TODD MOCCABEE (NPI# 1104481241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104481241 |
| Entity Type | Individual |
| Full Name | TODD MOCCABEE |
| Practice Address |
1920 Lakeland Hills Blvd Lakeland FL 33805-2902 |
| Mailing Address |
10506 Via Lugano Ct Clermont FL 34711-5435 |
| Practice Telephone | 8636834661 |
| Mailing Telephone | 7407086197 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2020-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
APRN11002195 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 102849000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2140 E Edgewood Dr, Lakeland, FL 338033604 | 8636691212 |
| Street Address |
1920 LAKELAND HILLS BLVD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33805-2902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326012527 | Jennifer Lynn Bath | Nurse Practitioner | 1920 Lakeland Hills Blvd, Lakeland, FL 33805-2902 | 2006-02-14 |
| 1447881289 | Saltzman, Tanis, Pittell, Levin and Jacobson, LLC | Pediatrics | 1920 Lakeland Hills Blvd, Lakeland, FL 33805-2902 | 2020-01-30 |
| 1801145040 | Ashley B Corn | Nurse Practitioner | 1920 Lakeland Hills Blvd, Lakeland, FL 33805-2902 | 2012-09-04 |
| 1568695898 | Jessica Marie Maxwell | Nurse Practitioner | 1920 Lakeland Hills Blvd, Lakeland, FL 33805-2902 | 2009-09-03 |
| 1447458047 | Stacy Ann Houghton | Nurse Practitioner | 1920 Lakeland Hills Blvd, Lakeland, FL 33805-2902 | 2007-07-05 |
| 1265465371 | Raypar Inc | Pediatrics | 1920 Lakeland Hills Blvd, Lakeland, FL 33805-2902 | 2006-07-09 |
| 1316911522 | Rachel Ann Ray | Pediatrics | 1920 Lakeland Hills Blvd, Lakeland, FL 33805-2902 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477188704 | Ernie Tairon Lugo | Nursing Home Administrator | 5210 State Road N 33, Lot 8, Lakeland, FL 33805 | 2020-03-06 |
| 1912546631 | Francis Esperanzate | Physical Therapist | 5070 Menlo Parke Way, Lakeland, FL 33805 | 2019-12-27 |
| 1689232514 | Anointed Touch | Home Health | 617 S Robson Street, Lakeland, FL 33805 | 2019-06-05 |
| 1083160642 | Cherlande Pierre | Chiropractor | 1507 Lakeland Hills Blvd Ste 109, Lakeland, FL 33805 | 2016-09-01 |
| 1992251706 | Damaris Salmeron | Physical Therapy Assistant | 3127 Us Hwy 98 N, Lakeland, FL 33805 | 2016-08-31 |
| 1831589076 | Sarah Mcneill | Pharmacist | 3124 Lakeland Hills Blvd, Lakeland, FL 33805 | 2015-01-26 |
| 1750706479 | Alison M Busby | Counselor | Achievement Academy Inc, 716 E. Bella Vista St, Lakeland, FL 33805 | 2014-03-04 |
| 1174872907 | William Vargas, M.d. P. A. | Anesthesiology | 202 Parkview Place, Lakeland, FL 33805 | 2012-09-07 |
| 1184998056 | Eduardo Francisco Lopez Garcia | Internal Medicine | 135 E First Street, Lakeland, FL 33805 | 2012-02-24 |
| 1255625513 | Navdeep Singh Jassal | Physical Medicine & Rehabilitation | 1417 Lakeland Hills Blvd Ste 201, Lakeland, FL 33805 | 2011-06-04 |
| Find all providers in zip 33805 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104353937 | Marlee Chang | Nurse Practitioner | 5652 Grandview Blvd, Lakeland, FL 33810-3239 | 2017-05-11 |
| 1184040891 | Sandrell Williams | Nurse Practitioner | 5133 S Lakeland Dr, Lakeland, FL 33813-2622 | 2014-03-05 |
| 1548539356 | Melissa Gaa Rumph | Nurse Practitioner | 601 S Florida Ave Ste 6, Lakeland, FL 33801-5237 | 2011-12-22 |
| 1003049990 | Adelene Soto | Nurse Practitioner | 930 Marcum Rd, Lakeland, FL 33809-4308 | 2009-08-26 |
| 1326012527 | Jennifer Lynn Bath | Nurse Practitioner | 1920 Lakeland Hills Blvd, Lakeland, FL 33805-2902 | 2006-02-14 |
| 1083273692 | Alexandra Texeira | Nurse Practitioner | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2019-06-07 |
| 1093235087 | Marron Mclean | Nurse Practitioner | 601 S Florida Ave Ste 6, Lakeland, FL 33801-5237 | 2017-06-21 |
| 1902343312 | Lachiana Hamilton | Nurse Practitioner | 5133 S Lakeland Dr, Lakeland, FL 33813-2622 | 2017-01-23 |
| 1699220079 | Jill Crutcher | Nurse Practitioner | 5950 S Florida Ave, Lakeland, FL 33813-2532 | 2016-08-16 |
| 1548676380 | Indya Carroll Dollison | Nurse Practitioner | 601 S Florida Ave, Lakeland, FL 33801-5237 | 2014-07-01 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.