Provider Demographics
NPI:1841088978
Name:MOORE, MICHELLE JENNIFER
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JENNIFER
Last Name:MOORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16335 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-8799
Mailing Address - Country:US
Mailing Address - Phone:352-620-5311
Mailing Address - Fax:
Practice Address - Street 1:16335 SW 19TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-8799
Practice Address - Country:US
Practice Address - Phone:352-620-5311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman Factors