Moderna Health Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MODERNA HEALTH CLINIC

Practice address

22 Broadway Ste 111
Kissimmee, FL 34741-5408

Phone

(407) 502-2520

Fax

(610) 638-0835

NPI assigned

Apr 20, 2021

Organization subpart

No

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

Authorized official

Name

Jonathan Torres, APRN

Title

Ceo

Phone

(407) 922-1184

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1467033415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 SARDINIA CIR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375863",
            "telephone_number": "407-502-2520",
            "fax_number": "610-638-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BROADWAY STE 111",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415408",
            "telephone_number": "407-502-2520",
            "fax_number": "610-638-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERNA HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-922-1184",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olabanjo J Mobayo
• Mary Kathryn Moberg, PHARMD
• Marta Moczo Santiago
• Model Pharmacy LLC
• Modern Podiatry, PA (Kevin Zasada DPM)
• Yesha Niranjan Modi, MD
• Francis Pamela Mogollon Duffo, M.D.
• Hannah Liz Mohabir, COTA/L
• Mohamed M. Zaman PLLC
• Mustafa B Mohamed, MD

• Primary Care Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.