Andrew Joseph Moffatt, MA, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL183 Issued in FL

Practice address

3127 W International Speedway Blvd
Daytona Beach, FL 32124-1070

Phone

(386) 258-9502

NPI assigned

Dec 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1265419667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 CYGNET LN",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327243772",
            "telephone_number": "386-822-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3127 W INTERNATIONAL SPEEDWAY BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241070",
            "telephone_number": "386-258-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFATT",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MA, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina A. Mitry-Hana, DPT, OTR/L
• Mja Healthcare of Florida, PC
• Mobile Counseling Services LLC
• Mobile Visiting Practitioners, LLC
• Kohei Mochizuki, LMHC
• Elizabeth Moffe
• Alicia Cherian Mohamed, APRN
• Zainab Furyal Mohammad, PA-C
• Kathleen D Molholm, LIMHP, LMHP; LPC
• Jose Guadalupe Molina, PT, DPT

• Athletic Trainer in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.