Healthcare Provider Details

I. General information

NPI: 1619813797
Provider Name (Legal Business Name): SIERRA MORENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3880 BIRD RD APT 315
MIAMI FL
33146-1537
US

IV. Provider business mailing address

3880 BIRD RD APT 315
MIAMI FL
33146-1537
US

V. Phone/Fax

Practice location:
  • Phone: 520-208-0918
  • Fax:
Mailing address:
  • Phone: 520-208-0918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: