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NPI Code Detail

MEDICARE: MRS. EILEEN GRACE MOYTON-LEWIN

MEDICARE:  MRS. EILEEN GRACE MOYTON-LEWIN
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
1164W00000XLicensed Practical NursePN5149416FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447753439
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EILEEN GRACE MOYTON-LEWIN
Provider Business Mailing Address
First Line : 4281 MANGO BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33411-9176
Country : US
Telephone Number : 561-255-9873
Fax Number : 561-328-3330
Provider Business Practice Location Address
First Line : 4281 MANGO BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33411-9176
Country : US
Telephone Number : 561-255-9873
Fax Number : 561-328-3330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2018
Last Update Date : 03/15/2018

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Directions to “ MRS. EILEEN GRACE MOYTON-LEWIN ” Practice Location

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