Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sidney Celine Moore, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1194699199

Sidney Celine Moore, PHYSICIANASSISTANT is a Physician Assistant in Port Orange, Florida. Qualified in 2025, 1 year ago. Practices as a sole proprietor and works from 3 locations.

Years since qualifying
1
In the registry since
2025
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Practice location Address checks out

1728 Dunlawton Ave Ste 5
Port Orange, FL 32127-2923
Phone: (386) 304-3404
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional 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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1194699199
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedOctober 2, 2025
Last updated in NPPESMarch 28, 2026
Certification dateMarch 28, 2026
Mailing address4850 Millenia Blvd, Orlando, FL 32839-6012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Port Orange