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NPI Code Detail

MEDICARE: MARIA ELANA MORA M.D.

MEDICARE:   MARIA ELANA MORA  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianME0065318FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043238132
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA ELANA MORA M.D.
Provider Business Mailing Address
First Line : 91 BRANSCOMB RD STE 3
Second Line :
City : GREEN COVE SPRINGS
State : FL
Zip : 32043-7222
Country : US
Telephone Number : 904-861-1034
Fax Number : 904-861-1037
Provider Business Practice Location Address
First Line : 91 BRANSCOMB RD STE 3
Second Line :
City : GREEN COVE SPRINGS
State : FL
Zip : 32043-7222
Country : US
Telephone Number : 904-861-1034
Fax Number : 904-861-1037
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 05/20/2026

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Directions to “ MARIA ELANA MORA M.D.” Practice Location

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