Healthcare Provider Details

I. General information

NPI: 1033308028
Provider Name (Legal Business Name): PATRICIA N MOODY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA MCNAB MD

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 BARTOW RD
LAKELAND FL
33801-5852
US

IV. Provider business mailing address

3110 CHERRY PALM DR STE 340
TAMPA FL
33619-8373
US

V. Phone/Fax

Practice location:
  • Phone: 863-683-7171
  • Fax:
Mailing address:
  • Phone: 813-932-0374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME111593
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberME111593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: