Maria E Mora MD PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MARIA E MORA MD PA

Practice address

91 Branscomb Rd Ste 3
Green Cove Springs, FL 32043-7222

Phone

(904) 861-1034

Fax

(904) 861-1037

NPI assigned

Jul 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maria Elena Mora, M.D.NPI 1043238132

Title

President

Phone

(904) 861-1034

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Middleburg Pediatrics Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Elana Mora, M.D.

  • Pediatrics Physician
  • Green Cove Springs, FL
  • NPI 1043238132
  Medicare reassignment NPD Authorized official
• Cari Dahlman, ARNP

  • Family Nurse Practitioner
  • Green Cove Springs, FL
  • NPI 1508153651
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704499200000",
    "number": "1184657306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 BRANSCOMB RD STE 3",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320437222",
            "telephone_number": "904-861-1034",
            "fax_number": "904-861-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 BRANSCOMB RD STE 3",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320437222",
            "telephone_number": "904-861-1034",
            "fax_number": "904-861-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA E MORA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2024-01-06",
        "certification_date": "2024-01-06",
        "status": "A",
        "authorized_official_last_name": "MORA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ELENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-861-1034",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104224",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271515500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middleburg Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Middleburg Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan A Lester
• Live Well Drugstore LLC
• Sharon Roseanne Lloyd, A.R.N.P.
• Chenel Denise Lowry-Wyatt, BSN RN
• Magnolia Urgent Care, PA
• Nicole Marquiss, M.A., L.M.H.C
• Faith Diana Martin- Coulter
• Brooke L Matsanka, PHARMD, RPH
• John Bernard McCabe, DMD
• Winona McCall, COTA, CLWTC

• Pediatrics Physician in Green Cove Springs, FL
• Providers in Green Cove Springs, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.