Healthcare Provider Details

I. General information

NPI: 1821943978
Provider Name (Legal Business Name): MORELAND WAY FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 BLACK MANGROVE LN
RIVERVIEW FL
33578-5603
US

IV. Provider business mailing address

10315 BLACK MANGROVE LN
RIVERVIEW FL
33578-5603
US

V. Phone/Fax

Practice location:
  • Phone: 757-810-3526
  • Fax:
Mailing address:
  • Phone: 757-810-3526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMBER MORELAND-HOLMES
Title or Position: REGISTERED AGENT/OWNER
Credential: APRN
Phone: 757-810-3526