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

Mrs. Mallory Moody Putnam, PA

Individual provider Medical Physician Assistant · NPI 1336493428

Mrs. Mallory Moody Putnam, PA is a Medical Physician Assistant in Lakeland, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2615 Fairmount Ave
Lakeland, FL 33803-3159
Phone: (863) 661-3887
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9106745 (FL)

Record details

NPI number1336493428
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedOctober 29, 2012
Last updated in NPPESJanuary 30, 2017

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients26
Services billed 26 a service is one billed item, such as a visit, a test or a procedure
Average patient age71

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Other providers in Lakeland