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NPI Code Detail

MEDICARE: DANIEL MORENO PTA

MEDICARE:   DANIEL  MORENO  PTA
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
1208100000XPhysical Medicine & Rehabilitation PhysicianPTA25940FL

General Provider Information

NPI Number : 1285116483
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL MORENO PTA
Provider Business Mailing Address
First Line : 4 HARVARD CIR STE 700
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33409-1989
Country : US
Telephone Number : 561-684-9200
Fax Number : 561-684-9202
Provider Business Practice Location Address
First Line : 4 HARVARD CIR STE 700
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33409-1989
Country : US
Telephone Number : 561-684-9200
Fax Number : 561-684-9202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2018
Last Update Date : 09/04/2018

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Directions to “ DANIEL MORENO PTA” Practice Location

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