Healthcare Provider Details

I. General information

NPI: 1780937771
Provider Name (Legal Business Name): CATHERINE MCLEOD-MOYA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 S.W. 80 ST SUITE 107
MIAMI FL
33143
US

IV. Provider business mailing address

1071 35TH AVE
VERO BEACH FL
32960-4049
US

V. Phone/Fax

Practice location:
  • Phone: 305-668-8644
  • Fax: 305-668-6010
Mailing address:
  • Phone: 305-904-5175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9465710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: