JACK WALTER MORA
NPI 1508759309
Nurse Anesthetist, Certified Registered in Fort Myers, FL
- Individual
- Male
- Nurse Anesthetist, Certified Registered
About JACK MORA
This page provides the complete NPI Profile along with additional information for Jack Mora, a provider established in Fort Myers, Florida with a medical specialization in Nurse Anesthetist, Certified Registered. The healthcare provider is registered in the NPI registry with number 1508759309 assigned on May 2025. The practitioner's primary taxonomy code is 367500000X with license number APRN11047887 (FL). The provider is registered as an individual and his NPI record was last updated June 2026.
- NPI
- 1508759309 Verify this NPI
- Provider Name
- JACK WALTER MORA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 8251 PATHFINDER LOOP APT 617 FORT MYERS, FL 33919
- Location Phone
- (239) 322-7732
- Mailing Address
- 8251 PATHFINDER LOOP APT 617 FORT MYERS, FL 33919
- Mailing Phone
- (239) 322-7732
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-30-2025
- Last Update Date
- 06-08-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Anesthetist, Certified Registered
- Taxonomy Code
- 367500000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- APRN11047887
- License State
- FL
- Taxonomy Description
- (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 163W00000X | Nursing Service Providers | Registered Nurse | 9555145 (FL) |
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508759309, enumerated as an "individual" on May 30, 2025.
The provider is located at 8251 PATHFINDER LOOP APT 617 FORT MYERS, FL 33919 and the phone number is (239) 322-7732.
Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
