| Doctor Name: | MRS. JEANIE MORAN |
| NPI Number: | 1154703163 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.S.F.A. |
| License Number: | 157619 |
| Business Practice Address: | 8146 Emerald Ave Parkland, FL - 330764429 |
| Business Phone Number: | 7087041887 |
| Business Fax Number: | |
| Mailing Address: | 8146 Emerald Ave, PARKLAND |
| State: | FL |
| Postal Code: | 330764429 |
| Phone Number: | 7087041887 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2015 |
| NPI Last Update Date: | 06/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 157619 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |