Provider Demographics
NPI:1780085175
Name:MORA, KARI-AVA (PA-C)
Entity type:Individual
Prefix:
First Name:KARI-AVA
Middle Name:
Last Name:MORA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARI-AVA
Other - Middle Name:
Other - Last Name:SHERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:300 PINELLAS ST
Mailing Address - Street 2:ATTN: BAY AREA EMERGENCY PHYSICIANS
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3804
Mailing Address - Country:US
Mailing Address - Phone:727-298-6612
Mailing Address - Fax:
Practice Address - Street 1:300 PINELLAS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3804
Practice Address - Country:US
Practice Address - Phone:727-298-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108179363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant