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General NPI Number Information
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NPI Number | 1033308028
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Entity Type | Individual
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Provider Name | PATRICIA N MOODY M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1125 BARTOW RD
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City | LAKELAND
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State | FL
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Zip | 33801-5852
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Country | US
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Telephone | 863-683-7171
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Fax |
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Provider Business Mailing Address
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Address Line | 3110 CHERRY PALM DR STE 340
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City | TAMPA
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State | FL
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Zip | 33619-8373
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Country | US
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Telephone | 813-932-0374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | ME111593
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | ME111593
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License Number State | FL
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