Healthcare Provider Details

I. General information

NPI: 1245156918
Provider Name (Legal Business Name): NIURKA MORENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8531 NW 139TH TER APT 1403
MIAMI LAKES FL
33016-6706
US

IV. Provider business mailing address

8531 NW 139TH TER APT 1403
MIAMI LAKES FL
33016-6706
US

V. Phone/Fax

Practice location:
  • Phone: 786-769-4932
  • Fax:
Mailing address:
  • Phone: 786-769-4932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number17859
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: