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NPI Code Detail

MEDICARE: ANNA NICOLE MOSKOVITZ

MEDICARE: ANNA NICOLE MOSKOVITZ
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
1363A00000XPhysician AssistantPA9116396FL

General Provider Information

NPI Number : 1649868761
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA NICOLE MOSKOVITZ
Provider Business Mailing Address
First Line : 98 S FEDERAL HWY
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-4825
Country : US
Telephone Number : 561-368-0777
Fax Number :
Provider Business Practice Location Address
First Line : 98 S FEDERAL HWY
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-4825
Country : US
Telephone Number : 561-368-0777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2021
Last Update Date : 09/27/2023

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Directions to “ ANNA NICOLE MOSKOVITZ ” Practice Location

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