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NPI Code Detail

MEDICARE: SHANNON ARLENE MOORE

MEDICARE: SHANNON ARLENE MOORE
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
1367H00000XAnesthesiologist Assistant

General Provider Information

NPI Number : 1821927658
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON ARLENE MOORE
Provider Business Mailing Address
First Line : 1410 BEACON HL
Second Line :
City : AFTON
State : VA
Zip : 22920-9600
Country : US
Telephone Number : 540-447-6370
Fax Number :
Provider Business Practice Location Address
First Line : 3100 E FLETCHER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33613-4613
Country : US
Telephone Number : 813-971-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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Directions to “ SHANNON ARLENE MOORE ” Practice Location

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