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General NPI Number Information
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NPI Number | 1386104370
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Entity Type | Individual
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Provider Name | TAMELA PATRICIA MOSES
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Gender | Female
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 1563 GEORGIA ST NE STE 3
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City | PALM BAY
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State | FL
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Zip | 32907-2565
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Country | US
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Telephone | 321-205-3557
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Fax |
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Provider Business Mailing Address
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Address Line | 1563 GEORGIA ST NE STE 3
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City | PALM BAY
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State | FL
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Zip | 32907-2565
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Country | US
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Telephone | 321-465-2288
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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 | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number | 235330
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License Number State | FL
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