Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Kelly L. Moores, PA-C

Individual provider Surgical Physician Assistant · NPI 1417937194

Mr. Kelly L. Moores, PA-C is a Physician Assistant in Lakeland, Florida. Graduated from Saint Louis University School of Medicine in 1995, 31 years ago. Practices with Lakeland Regional Health Systems Inc, a 503-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
31
Trained at
Saint Louis University School of Medicine
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2400 Kathleen Rd
Lakeland, FL 33810-3077
Phone: (863) 687-1250
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3030 Harden Blvd, Lakeland, FL 33803-7952 — (863) 687-1250

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1417937194
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 19, 2006
Last updated in NPPESFebruary 11, 2026
Certification dateFebruary 11, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1995 (31 years in practice)
Group practice Lakeland Regional Health Systems Inc — 503 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Lakeland