JEFFREY LANG MOULTON (NPI# 1518009612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518009612 |
| Entity Type | Individual |
| Full Name | JEFFREY LANG MOULTON |
| Credential | PA-C |
| Practice Address |
4200 N Armenia Ave Ste 1-2 Tampa FL 33607-6438 |
| Mailing Address |
2400 Bellevue Rd Ste 21a Dublin GA 31021-2890 |
| Practice Telephone | 8138774811 |
| Practice Fax Number | 8138728978 |
| Mailing Telephone | 4783280281 |
| Mailing Fax Number | 4783280438 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 3652 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9110559 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
3652 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3652 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831324433 | Jeffrey Glenn Moulton | Speech-Language Pathologist | 7025 Sierra Club Cir Apt 6105, Naples, FL 34113-7360 | 2009-05-27 |
| 1164491361 | Jeffrey S Moulton | Radiology | 11600 W 2nd Pl, Lakewood, CO 80228-1527 | 2006-03-17 |
| Street Address |
4200 N ARMENIA AVE STE 1-2 |
| City | TAMPA |
| State | FL |
| Zip Code | 33607-6438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326656265 | Sky City Pharmacy LLC | Pharmacy | 2812 W. Dr Martin Luther King Jr Blvd, Tampa, FL 33607 | 2020-07-16 |
| 1821614413 | Tammy Sue Alleyn | Social Worker | 4414 N. Armenia Av., Tampa, FL 33607 | 2020-06-19 |
| 1912528290 | Advanced Mobile Medical Services | Clinic/Center | 2136 W. Mlk Blvd, Tampa, FL 33607 | 2020-04-28 |
| 1659909232 | Rachel Sobiech | Social Worker | 2006 Pan Am Circle, Suite 270, Tampa, FL 33607 | 2020-03-30 |
| 1295379733 | Melizza Liz Sanchez Ayala | Registered Nurse | 1701 N Lois Avenue, Valera Apt Unit 224, Tampa, FL 33607 | 2019-10-28 |
| 1720647191 | Caretyme LLC | Clinic/Center | 1923 West St. John Street, Tampa, FL 33607 | 2019-06-10 |
| 1720545981 | Amante Medical and Diabetic Center, P.a. | Internal Medicine | 1001 N Macdill Ave. Suite B, Tampa, FL 33607 | 2019-02-25 |
| 1609360908 | Misty Dawn Ray Ross | Social Worker | 2902 N Armenia Ave Ste 200, Tampa, FL 33607 | 2018-06-20 |
| 1255825154 | Kenneth Konrad Schirer | Physical Therapist | 2700 W Dr. Mlk Blvd, Suite 300, Tampa, FL 33607 | 2018-06-14 |
| 1902314875 | Cardiac Cin of Florida, LLC | Internal Medicine | 3001 W Martin Luther King Jr Blvd, Tampa, FL 33607 | 2018-01-13 |
| Find all providers in zip 33607 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762046 | Samantha Martin | Physician Assistant | 12950 Race Track Rd Ste 106, Tampa, FL 33626-1304 | 2020-05-28 |
| 1124648159 | Christian Otero | Physician Assistant | 311 W Palm Ave, Tampa, FL 33602-2029 | 2020-04-20 |
| 1487219036 | Vanessa Natasha White | Physician Assistant | 10205 W Hillsborough Ave Ste B, Tampa, FL 33615-3671 | 2019-05-08 |
| 1518520873 | Zachary Luke Ulshafer | Physician Assistant | 12901 Bruce B Downs Blvd # 05, Tampa, FL 33612-4742 | 2019-04-22 |
| 1548756893 | Christopher Jacob Bordelon | Physician Assistant | 2550 W Dr Martin Luther King Jr Blvd Ste B, Tampa, FL 33607-6302 | 2018-07-10 |
| 1871033340 | Amanda Lins Chissell | Physician Assistant | 13801 Bruce B Downs Blvd Ste 231, Tampa, FL 33613-3946 | 2017-03-03 |
| 1669839767 | Barbara N Vargas | Physician Assistant | 12500 N Dale Mabry Hwy Ste A, Tampa, FL 33618-2809 | 2016-01-20 |
| 1215305776 | Amber Lubas | Physician Assistant | 401 N Rome Ave, Apt: 4314, Tampa, FL 33606-0009 | 2015-09-14 |
| 1972988467 | Karla Michelle Mincone | Physician Assistant | 3040 W Cypress St # 103, Tampa, FL 33609-1615 | 2015-07-25 |
| 1326441767 | Brigett Brandjes | Physician Assistant | 2902 Usf Magnolia Drive, Tampa, FL 33612 | 2014-09-30 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.