Healthcare Provider Details

I. General information

NPI: 1346172657
Provider Name (Legal Business Name): VIOLETA ISABEL MORA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIOLETA ISABEL MORA ABALLE

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

2200 FOWLER GROVE BLVD STE 200
WINTER GARDEN FL
34787-5597
US

IV. Provider business mailing address

2200 FOWLER GROVE BLVD STE 200
WINTER GARDEN FL
34787-5597
US

V. Phone/Fax

Practice location:
  • Phone: 407-271-3607
  • Fax:
Mailing address:
  • Phone: 407-271-3607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN45499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: