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NPI Code Detail

MEDICARE: MARAY MOLDON APRN

MEDICARE: MARAY MOLDON APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN11012092FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2APRN11012092OTHERFLFL MEDICAL LICENSE

General Provider Information

NPI Number : 1669057147
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARAY MOLDON APRN
Provider Business Mailing Address
First Line : 425 W COLONIAL DR STE 303
Second Line :
City : ORLANDO
State : FL
Zip : 32804-6863
Country : US
Telephone Number : 407-382-1376
Fax Number : 833-450-5418
Provider Business Practice Location Address
First Line : 1501 S SEMORAN BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-2919
Country : US
Telephone Number : 407-587-7552
Fax Number : 833-450-5422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2021
Last Update Date : 08/01/2025

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