MEDICARE: YAMILET ALBERTO MOYA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11014497	FL

General Provider Information

NPI Number	:	1225702491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMILET ALBERTO MOYA NP

Provider Business Mailing Address
First Line	:	4901 PALM BEACH BLVD UNIT 400
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-3235
Country	:	US
Telephone Number	:	239-237-2133
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 PALM BEACH BLVD UNIT 400
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-3235
Country	:	US
Telephone Number	:	239-237-2133
Fax Number	:	754-222-6417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	08/01/2024

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