Telepractitioners

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

TELEPRACTITIONERS

Practice address

6440 Devesta Loop
Palmetto, FL 34221-2373

Phone

(813) 735-9164

NPI assigned

Jun 30, 2022

Organization subpart

No

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

Authorized official

Name

Ketan Moran

Title

Owner

Phone

(813) 735-9164

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1275265993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 DEVESTA LOOP",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342212373",
            "telephone_number": "813-735-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 DEVESTA LOOP",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342212373",
            "telephone_number": "813-735-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELEPRACTITIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "KETAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-735-9164"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Palmetto, FL
• Providers in Palmetto, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.