Healthcare Provider Details

I. General information

NPI: 1972435105
Provider Name (Legal Business Name): A FRESH PERSPECTIVE ON LIFE AND RELATIONSHIPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 SW 1ST AVE
OCALA FL
34471-0921
US

IV. Provider business mailing address

1056 SW 1ST AVE
OCALA FL
34471-0921
US

V. Phone/Fax

Practice location:
  • Phone: 352-850-5776
  • Fax:
Mailing address:
  • Phone: 352-850-5776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY RANDOLPH MOORE
Title or Position: PROVIDER
Credential: LMFT
Phone: 352-850-5776