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General NPI Number Information
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NPI Number | 1144117649
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Entity Type | Individual
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Provider Name | LYDIA SOPHIA MOJICA
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Gender |
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 807 ESPANOLA WAY
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City | MELBOURNE
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State | FL
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Zip | 32901-4103
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Country | US
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Telephone | 407-738-9978
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Fax |
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Provider Business Mailing Address
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Address Line | 807 ESPANOLA WAY
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City | MELBOURNE
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State | FL
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Zip | 32901-4103
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Country | US
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Telephone | 407-738-9978
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | W4B8F9R2
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License Number State | FL
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