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General NPI Number Information
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NPI Number | 1376596205
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Entity Type | Individual
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Provider Name | ROBERTO ANDRES MOYA M.D., P.A.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 2140 W 68TH ST SUITE 201
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City | HIALEAH
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State | FL
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Zip | 33016-1815
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Country | US
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Telephone | 305-826-4046
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Fax | 305-556-6271
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Provider Business Mailing Address
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Address Line | 2140 W 68TH ST SUITE 201
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City | HIALEAH
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State | FL
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Zip | 33016-1815
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Country | US
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Telephone | 305-826-4046
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Fax | 305-556-6271
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME31217
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License Number State | FL
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