MEDICARE: MS. SORAIDA MOJICA-ARIAS

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	106H00000X	Marriage & Family Therapist	IMT3703	FL

General Provider Information

NPI Number	:	1588369474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SORAIDA MOJICA-ARIAS

Provider Business Mailing Address
First Line	:	1115 GREEN PINE BLVD APT D1
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-7057
Country	:	US
Telephone Number	:	954-347-8018
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 GREEN PINE BLVD APT D1
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-7057
Country	:	US
Telephone Number	:	954-347-8018
Fax Number	:

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

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	04/03/2023

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