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NPI Code Detail

MEDICARE: KERVIN MOYA MORAN

MEDICARE:   KERVIN  MOYA MORAN
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
1106S00000XBehavior TechnicianRBT-24-341734FL

General Provider Information

NPI Number : 1437906179
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERVIN MOYA MORAN
Provider Business Mailing Address
First Line : 9520 SW 40TH ST STE 207
Second Line :
City : MIAMI
State : FL
Zip : 33165-4074
Country : US
Telephone Number : 786-615-5701
Fax Number :
Provider Business Practice Location Address
First Line : 9520 SW 40TH ST STE 207
Second Line :
City : MIAMI
State : FL
Zip : 33165-4074
Country : US
Telephone Number : 786-615-5701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2024
Last Update Date : 09/11/2024

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Directions to “ KERVIN MOYA MORAN ” Practice Location

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