Healthcare Provider Details

I. General information

NPI: 1710832936
Provider Name (Legal Business Name): BRITTANY LYNN MOYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY LYNN WALTMAN

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13450 NW 104TH TER
ALACHUA FL
32615-5608
US

IV. Provider business mailing address

7450 SW 5TH AVE
OCALA FL
34476-6802
US

V. Phone/Fax

Practice location:
  • Phone: 352-757-2711
  • Fax: 352-744-0415
Mailing address:
  • Phone: 570-716-5321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11045687
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: