MEDICARE: MARIA VIOLA MOISE

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1922725738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA VIOLA MOISE

Provider Business Mailing Address
First Line	:	3800 INVERRARY BLVD STE 408F
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-4359
Country	:	US
Telephone Number	:	786-357-9854
Fax Number	:

Provider Business Practice Location Address
First Line	:	4933 NW 43RD ST
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-4637
Country	:	US
Telephone Number	:	786-357-9854
Fax Number	:	954-827-2424

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

Provider Enumeration Date	:	10/24/2022
Last Update Date	:	10/24/2022

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Directions to “ MARIA VIOLA MOISE ” Practice Location

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