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NPI Code Detail

MEDICARE: MOYA-PRIDA MD

MEDICARE: MOYA-PRIDA MD
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
1207R00000XInternal Medicine Physician
2363LF0000XFamily Nurse Practitioner
3261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558224675
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOYA-PRIDA MD
Provider Business Mailing Address
First Line : 1460 S PALM AVE
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33025-5520
Country : US
Telephone Number : 954-239-7486
Fax Number : 954-376-7289
Provider Business Practice Location Address
First Line : 7911 NW 72ND AVE STE 111
Second Line :
City : MEDLEY
State : FL
Zip : 33166-2221
Country : US
Telephone Number : 305-888-6959
Fax Number : 954-376-7289
Authorized Official
Title or Position : PRESIDENT
Name : JAYNIER MOYA
Credential : MD
Telephone Number : 954-239-7486
Provider Enumeration Date : 12/05/2025
Last Update Date : 12/05/2025

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Directions to “MOYA-PRIDA MD ” Practice Location

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