Active NPI
Carole Mallonee Moffitt, PT
- Physical Therapist
- Saint Cloud, FL
National Provider Identifier
1972646719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 3010
- Practice address
- 1361 E Irlo Bronson Memorial Hwy
Saint Cloud, FL 34771-5823 - Phone
- (407) 957-1454
- Fax
- (407) 957-1706
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 3010 | FL | Primary |
Addresses
Primary practice location
1361 E Irlo Bronson Memorial Hwy
Saint Cloud, FL 34771-5823
Mailing address
5295 Starline Dr
Saint Cloud, FL 34771-9030
Phone (407) 791-6943
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 3010 | FL | MD | Physical Therapist |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972646719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5295 STARLINE DR",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347719030",
"telephone_number": "407-791-6943",
"fax_number": "407-957-1706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1361 E IRLO BRONSON MEMORIAL HWY",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347715823",
"telephone_number": "407-957-1454",
"fax_number": "407-957-1706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFFITT",
"first_name": "CAROLE",
"middle_name": "MALLONEE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 3010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.