1548591258 NPI number — MONIQUE M MOYA L.M., RN

Table of content: MONIQUE M MOYA L.M., RN (NPI 1548591258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548591258 NPI number — MONIQUE M MOYA L.M., RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOYA
Provider First Name:
MONIQUE
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.M., RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548591258
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2214 NW 15TH WAY
Provider Second Line Business Mailing Address:
BOX 639
Provider Business Mailing Address City Name:
BOYNTON BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33436-2815
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-547-7056
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2214 NW 15TH WAY
Provider Second Line Business Practice Location Address:
BOX 639
Provider Business Practice Location Address City Name:
BOYNTON BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33436-2815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-547-7056
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/20/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  NUR-RN-LIC-127517 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WM0102X , with the licence number: RN9471287 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: MW238 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MW238 . This is a "COUNCIL OF LICENSED MIDWIFERY" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 021234300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: NUR-RN-LIC-127517 . This is a "BOARD OF NURSING" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: RN9471287 . This is a "BOARD OF NURSING" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".