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General NPI Number Information
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NPI Number | 1831409945
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Entity Type | Organization
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Legal Business Name | GILDA P MORENO PSY D PA
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 8525 SW 92ND ST SUITE A-1
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City | MIAMI
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State | FL
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Zip | 33156-7365
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Country | US
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Telephone | 305-630-2909
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Fax | 305-630-2908
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Provider Business Mailing Address
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Address Line | 8525 SW 92ND ST SUITE A-1
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City | MIAMI
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State | FL
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Zip | 33156-7365
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Country | US
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Telephone | 305-630-2909
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Fax | 305-630-2908
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Authorized Official
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Title or Position | PRESIDENT
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Name | GILDA P MORENO
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Credential | PSYD
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Telephone | 305-630-2909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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