RONALD JASON MOORE (NPI# 1316902679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316902679 |
| Entity Type | Individual |
| Full Name | RONALD JASON MOORE |
| Credential | PA-C |
| Practice Address |
3310 Waterman Way Tavares FL 32778-5250 |
| Practice Telephone | 3523431216 |
| Practice Fax Number | 3523431582 |
| Mailing Telephone | 3523431216 |
| Mailing Fax Number | 3523431582 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2020-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9102945 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9102945 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9102945 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RR MEDICARE | P00414081 | 01 |
| FL | BCBS | U4075 | 01 |
| FL | BCBS OF FL | Y04L4 | 01 |
| FL | RR MEDICARE | P00702090 | 01 |
| FL | 292533800 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 700 Doctors Ct, Leesburg, FL 347487314 | 3527879838 | 3526225771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235697236 | Ronald Carl Moore IIi | Specialist/Technologist | 208 Shivers Run Ct, Mullica Hill, NJ 08062-4732 | 2019-03-08 |
| 1942600267 | Ronald Edwin Moore | Pharmacist | 13906 Hootsell Ct, Baton Rouge, LA 70816-2719 | 2014-08-25 |
| 1578805123 | Ronald Barry Moore | Nurse Practitioner | 101 W Cooperative Way Ste 110, Georgetown, TX 78626-8209 | 2013-03-21 |
| 1487930210 | Ronald Craig Moore | Counselor | 525 S 13th St, Las Vegas, NV 89101-7203 | 2011-10-25 |
| 1801009808 | Ronald Eric Moore | Chiropractor | 137 Hughes Rd, Madison, AL 35758-1109 | 2007-05-07 |
| 1184741936 | Ronald J Moore | Chiropractor | 206 W First Street, Suite G, Deer Park, WA 99006 | 2007-03-26 |
| 1417098674 | Ronald Moore | Dentist | 25835 Barton Rd Ste 104, Loma Linda, CA 92354 | 2007-02-09 |
| 1801402136 | Ronald Pete Moore | Physical Therapy Assistant | 2312 S Dixon Rd, Kokomo, IN 46902-6401 | 2020-09-22 |
| 1487079133 | Ronald R Moore | Dentist | 11012 N Radio Station Rd, Seneca, SC 29678-1142 | 2014-03-04 |
| 1114367646 | Ronald Lynn Moore Sr. | Behavioral Analyst | 5720 Oakwood St, Spencer, OK 73084-8639 | 2013-06-28 |
| Street Address |
3310 WATERMAN WAY |
| City | TAVARES |
| State | FL |
| Zip Code | 32778-5250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023476033 | Central Florida Premier Eye Associates | Non-Pharmacy Dispensing Site | 3310 Waterman Way, Tavares, FL 32778-5250 | 2016-02-04 |
| 1942400262 | Vinay K. Gutti | Ophthalmology | 3310 Waterman Way, Tavares, FL 32778-5250 | 2007-07-24 |
| 1467533505 | Scot Corbin Holman | Ophthalmology | 3310 Waterman Way, Tavares, FL 32778-5250 | 2006-10-17 |
| 1326076274 | Wistar Moore IIi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3310 Waterman Way, Tavares, FL 32778-5250 | 2006-06-29 |
| 1992745418 | Mark J Vocci | Ophthalmology | 3310 Waterman Way, Tavares, FL 32778-5250 | 2006-06-07 |
| 1174563696 | Scott Wehrly | Ophthalmology | 3310 Waterman Way, Tavares, FL 32778-5250 | 2006-06-07 |
| 1972543312 | Shelby L Terpstra | Ophthalmology | 3310 Waterman Way, Tavares, FL 32778-5250 | 2006-06-07 |
| 1013956986 | Central Florida Premier Eye Associates | Ophthalmology | 3310 Waterman Way, Tavares, FL 32778-5250 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487173753 | Erica Denise Irvin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4681 Marsh Harbor Dr, Tavares, FL 32778 | 2017-09-18 |
| 1922522499 | J&t Divine Care | Home Health | 1554 Auburn Hills Ct, Tavares, FL 32778 | 2017-07-27 |
| 1841738721 | Kelli Maragh | Behavior Technician | 12237 Tavares Ridge Circle, Tavares, FL 32778 | 2017-02-10 |
| 1831633692 | Amanda Williams Sellers | Nurse Practitioner | 1858 Mayo Dr, Tavares, FL 32778 | 2016-12-13 |
| 1235680042 | Natalie Roaine Ash-maheux | Occupational Therapist | 4501 Waterman Way, Tavares, FL 32778 | 2016-10-17 |
| 1396295713 | Sumiko Burley- Collins | Community Health Worker | 1572 Auburn Hills Court, Tavares, FL 32778 | 2016-10-10 |
| 1295100980 | Sunshine Therapy Group, Pa | Speech-Language Pathologist | 2050 Classique Lane, Tavares, FL 32778 | 2015-12-06 |
| 1093188385 | Jana Michelle England | Counselor | 1300 Duncan, Tavares, FL 32778 | 2015-11-09 |
| 1467865980 | Reshma Balmick | Hearing Instrument Specialist | 500 West Burleigh Blvd., Tavares, FL 32778 | 2014-06-03 |
| 1861825739 | Shelagh Kathryn Wood-gouveia | Nurse Practitioner | 1390 East Burleigh Blvd., Tavares, FL 32778 | 2013-08-15 |
| Find all providers in zip 32778 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417578832 | Breanne Williamson | Physician Assistant | 3207 Landing Vw, Tavares, FL 32778-2050 | 2020-04-27 |
| 1356314736 | Daniel E Drake | Physician Assistant | 2051 Mayo Dr, Tavares, FL 32778 | 2006-02-08 |
| 1659927390 | Madeline Jensen | Physician Assistant | 1816 Salk Ave, Tavares, FL 32778-4300 | 2019-08-16 |
| 1174099733 | Crystal Hudson | Physician Assistant | 2146 Vindale Rd, Tavares, FL 32778-5602 | 2018-10-22 |
| 1477093706 | Shaunte Wilks | Physician Assistant | 1816 Salk Ave, Tavares, FL 32778-4300 | 2017-03-06 |
| 1487015939 | Michelle L Hopkins | Physician Assistant | 1816 Salk Ave, Tavares, FL 32778-4300 | 2016-03-11 |
| 1346613676 | Shivali G Patel | Physician Assistant | 3150 Waterman Way, Tavares, FL 32778-5252 | 2015-11-09 |
| 1619393121 | Regina Leigh Christian | Physician Assistant | 1210 Waterman Way, Tavares, FL 32778-5229 | 2014-03-07 |
| 1215278783 | Richard Olton | Physician Assistant | 2523 Dora Ave, Tavares, FL 32778-4977 | 2013-03-08 |
| 1720211451 | Theresa A D'avila | Physician Assistant | 3120 Waterman Way, Tavares, FL 32778-5252 | 2009-08-28 |
| Find all providers in TAVARES | ||||
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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.