Bonnie Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101875 Issued in FL

Practice address

38029 Arbor Ridge Dr
Zephyrhills, FL 33540-1301

Phone

(813) 783-3811

Fax

(813) 788-1087

NPI assigned

Jul 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Medical Clinic LLC

  • Clinic/Center
  • Zephyrhills, FL
  • NPI 1821055690
  NPD (past)
• Florida Medical Clinic, LLC

  • Pharmacy
  • Zephyrhills, FL
  • NPI 1669548020
  NPD (past)

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1528097375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-780-1255",
            "fax_number": "813-780-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38029 ARBOR RIDGE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335401301",
            "telephone_number": "813-783-3811",
            "fax_number": "813-788-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BONNIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00078818",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darlene Montani, MSN APRN FNP-BC ONC
• David Joel Montero
• Natasha Andrea Montero, COTA/L
• Ashley Rose Monthervil
• Michael Montuno, MD
• Lauren Elizabeth Moore, PA-C
• Richard L Moore, MD
• Robert Jay Moore III
• Shantell Taheerah Moore
• Anetha Moorthal, M.D

• Physician Assistant in Zephyrhills, FL
• Providers in Zephyrhills, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.