Healthcare Provider Details

I. General information

NPI: 1255424636
Provider Name (Legal Business Name): FLOR VENERACION MOYA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FLORDELIZA VENERACION MOYA ARNP

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MIAMI VA HEALTH CARE SYSTEM 1201 NW 16TH STREET
MIAMI FL
33137
US

IV. Provider business mailing address

2275 BISCAYNE BOULEVARD # 801
MIAMI FL
33137
US

V. Phone/Fax

Practice location:
  • Phone: 305-324-4455
  • Fax: 305-575-3149
Mailing address:
  • Phone: 305-573-7833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1017572
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: