Provider Demographics
NPI:1275141574
Name:MOYA, DANEIRY (ESE TEACHER)
Entity Type:Individual
Prefix:
First Name:DANEIRY
Middle Name:
Last Name:MOYA
Suffix:
Gender:F
Credentials:ESE TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7007 SEABURY CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-2958
Mailing Address - Country:US
Mailing Address - Phone:813-453-0502
Mailing Address - Fax:
Practice Address - Street 1:7007 SEABURY CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-2958
Practice Address - Country:US
Practice Address - Phone:813-453-0502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103760200Medicaid