MEDICARE: CASEY BLAINE MOORE APRN

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
1	363LF0000X	Family Nurse Practitioner	ARNP 9267893	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00927067	OTHER	FL	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1942434998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY BLAINE MOORE APRN

Provider Business Mailing Address
First Line	:	2710 REW CIR STE 200
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-2967
Country	:	US
Telephone Number	:	668-389-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	5375 SCHOOL RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652
Country	:	US
Telephone Number	:	888-373-0013
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2009
Last Update Date	:	04/13/2026

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