MEDICARE: ANYLIN MORENO ARNP

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
1	363LF0000X	Family Nurse Practitioner	APRN11024203	FL

General Provider Information

NPI Number	:	1770289852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANYLIN MORENO ARNP

Provider Business Mailing Address
First Line	:	4100 SALZEDO ST STE 4
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-1751
Country	:	US
Telephone Number	:	786-227-6811
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 SALZEDO ST STE 4
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-1751
Country	:	US
Telephone Number	:	786-227-6811
Fax Number	:	786-732-2377

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2023
Last Update Date	:	02/01/2023

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