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NPI Code Detail

MEDICARE: VILKA M MOONSAMMY

MEDICARE: VILKA M MOONSAMMY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse355882-1NY

General Provider Information

NPI Number : 1063975860
Entity Type Code : Individual
Provider Name (Legal Business Name) : VILKA M MOONSAMMY
Provider Business Mailing Address
First Line : 3953 VALENCIA GROVE LN
Second Line :
City : ORLANDO
State : FL
Zip : 32817-1727
Country : US
Telephone Number : 407-489-6731
Fax Number :
Provider Business Practice Location Address
First Line : 3953 VALENCIA GROVE LN
Second Line :
City : ORLANDO
State : FL
Zip : 32817-1727
Country : US
Telephone Number : 407-489-6731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2019
Last Update Date : 04/09/2019

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Directions to “ VILKA M MOONSAMMY ” Practice Location

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