Jared Dylan Moore, FNP-BC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11025879 Issued in FL

Practice address

205 W Dr Martin Luther King Jr Blvd Ste 103
Tampa, FL 33603-3600

Phone

(813) 364-2069

NPI assigned

Apr 21, 2023

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1427745140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7417 33RD AVE S",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336196462",
            "telephone_number": "813-364-2069",
            "fax_number": "866-560-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W DR MARTIN LUTHER KING JR BLVD STE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033600",
            "telephone_number": "813-364-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JARED",
        "middle_name": "DYLAN",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-21",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11025879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esperanza Moore
• Garry Moore
• Glenn Moore, LMT
• Holly Ann Moore
• Janel Nicole Moore, APRN
• Jason Michael Moore, D.M.D.
• Jay Winston Moore, PH.D., FACMG
• Jerrica Chambers Moore, PA-C
• Joanne Marie Moore
• Jonette Rae Moore, ARNP

• Family Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.