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General NPI Number Information
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NPI Number | 1780204610
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Entity Type | Organization
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Legal Business Name | CAYA HEALTH
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 801 INTERNATIONAL PKWY STE 500
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City | LAKE MARY
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State | FL
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Zip | 32746-4763
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Country | US
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Telephone | 407-496-3549
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Fax |
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Provider Business Mailing Address
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Address Line | 801 INTERNATIONAL PKWY STE 500
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City | LAKE MARY
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State | FL
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Zip | 32746-4763
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Country | US
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Telephone | 407-496-3549
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Fax |
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Authorized Official
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Title or Position | COE/ MEDICAL DIRECTOR
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Name | DR. ERIC MOORE
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Credential | MD
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Telephone | 407-496-3549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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