Healthcare Provider Details

I. General information

NPI: 1871546788
Provider Name (Legal Business Name): DAPHNEE MOISE-JOHNSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAPHNEE MOISE MD

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 BEE RIDGE RD
SARASOTA FL
34239-7115
US

IV. Provider business mailing address

6214 MEMORIAL HWY STE B
TAMPA FL
33615-4507
US

V. Phone/Fax

Practice location:
  • Phone: 941-927-1234
  • Fax: 921-921-0043
Mailing address:
  • Phone: 800-574-9491
  • Fax: 800-547-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME93843
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME93843
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License NumberME93843
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: