Provider Demographics
NPI:1083247944
Name:MOYA, MELISSA BARBARA (APRN, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:BARBARA
Last Name:MOYA
Suffix:
Gender:F
Credentials:APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13501 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1111
Mailing Address - Country:US
Mailing Address - Phone:786-835-8447
Mailing Address - Fax:
Practice Address - Street 1:13501 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-1111
Practice Address - Country:US
Practice Address - Phone:786-835-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005872363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care