Healthcare Provider Details

I. General information

NPI: 1558082156
Provider Name (Legal Business Name): JOSE MANUEL MOYA DE ARMAS FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 03/18/2023
Certification Date: 03/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13306 SW 128TH ST
MIAMI FL
33186-5899
US

IV. Provider business mailing address

13306 SW 128TH ST
MIAMI FL
33186-5899
US

V. Phone/Fax

Practice location:
  • Phone: 305-424-9060
  • Fax: 305-363-4412
Mailing address:
  • Phone: 305-424-9060
  • Fax: 305-363-4412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11022286
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: