Healthcare Provider Details

I. General information

NPI: 1003797291
Provider Name (Legal Business Name): ZURAIKA MOYA TAUILE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/12/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6551 NW 38TH TER APT 3
VIRGINIA GARDENS FL
33166-6972
US

IV. Provider business mailing address

6551 NW 38TH TER APT 3
VIRGINIA GARDENS FL
33166-6972
US

V. Phone/Fax

Practice location:
  • Phone: 954-665-0217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11042150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: