| Doctor Name: | MICHELE JEANETTE MOORE |
| NPI Number: | 1043560097 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 695832 |
| Business Practice Address: | 801 International Pkwy Suite 500 Lake Mary, FL - 327464762 |
| Business Phone Number: | 8635125333 |
| Business Fax Number: | |
| Mailing Address: | 801 International Pkwy, Suite 500 LAKE MARY |
| State: | FL |
| Postal Code: | 327464762 |
| Phone Number: | 8635125333 |
| Fax Number: | |
| NPI Enumeration Date: | 09/18/2012 |
| NPI Last Update Date: | 11/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 695832 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |