Healthcare Provider Details

I. General information

NPI: 1467109496
Provider Name (Legal Business Name): SARAI MOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4854 NW 7TH ST APT 505
MIAMI FL
33126-2189
US

IV. Provider business mailing address

4854 NW 7TH ST APT 505
MIAMI FL
33126-2189
US

V. Phone/Fax

Practice location:
  • Phone: 786-454-5175
  • Fax:
Mailing address:
  • Phone: 786-454-5175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: