Healthcare Provider Details

I. General information

NPI: 1326575291
Provider Name (Legal Business Name): ZUNEYDY BARBARA MOYA VIVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 05/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10650 W STATE ROAD 84 STE 206
DAVIE FL
33324-4235
US

IV. Provider business mailing address

4361 NW 174TH DR
MIAMI GARDENS FL
33055-3711
US

V. Phone/Fax

Practice location:
  • Phone: 954-634-3636
  • Fax: 954-634-3637
Mailing address:
  • Phone: 786-970-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: