Healthcare Provider Details

I. General information

NPI: 1134501067
Provider Name (Legal Business Name): YUNIET MOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2015
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8960 COLONIAL CENTER DR STE 300
FORT MYERS FL
33905-7810
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-9470
  • Fax: 239-343-9498
Mailing address:
  • Phone: 239-343-9470
  • Fax: 239-343-9498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME135664
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number31772 R
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: