Healthcare Provider Details

I. General information

NPI: 1366625329
Provider Name (Legal Business Name): OSMARY MOYA LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 03/15/2025
Certification Date: 03/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 W 64TH PL APT 106
HIALEAH FL
33016-4336
US

IV. Provider business mailing address

2785 W 64TH PL APT 106
HIALEAH FL
33016-4336
US

V. Phone/Fax

Practice location:
  • Phone: 786-318-4789
  • Fax:
Mailing address:
  • Phone: 305-269-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA39827
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-418087
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: