Sidney Celine Moore, PHYSICIAN ASSISTANT

Physician Assistant · Port Orange, FL

Individual Active NPI

NPI number 1194699199

Practice location

1728 Dunlawton Ave Ste 5
Port Orange, FL 32127-2923
Phone
(386) 304-3404

Open in Google Maps

NPI record

NPI
1194699199
Entity type
Individual (Type 1)
Enumeration date
October 2, 2025
Last updated
March 28, 2026
Certified
March 28, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X — —

Mailing address

4850 Millenia Blvd
Orlando, FL 32839-6012

Other practice locations (2)

  • 325 Clyde Morris Blvd Ste 300, Ormond Beach, FL 32174-8179 · (386) 304-3404
  • 385 Palm Coast Pkwy SW Unit 2, Palm Coast, FL 32137-4784 · (386) 304-1811

About Sidney Moore

Sidney Celine Moore, PHYSICIAN ASSISTANT is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 1728 Dunlawton Ave Ste 5, Port Orange, FL 32127-2923. The NPI number 1194699199 was assigned on October 2, 2025 and the record was last updated on March 28, 2026.

Frequently asked questions

What is the NPI number of Sidney Celine Moore, PHYSICIAN ASSISTANT?

The NPI number is 1194699199.

What is the phone number of Sidney Moore?

The phone number listed for the practice location is (386) 304-3404.

Where is Sidney Moore located?

1728 Dunlawton Ave Ste 5, Port Orange, FL 32127-2923.

What is the taxonomy code for Sidney Moore?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Physician Assistant providers in Port Orange

All Physician Assistant providers in Port Orange, FL →