Provider Demographics
NPI:1275202996
Name:DORSEY-MOORE, JUSTICE SIMONE (CNM)
Entity Type:Individual
Prefix:
First Name:JUSTICE
Middle Name:SIMONE
Last Name:DORSEY-MOORE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:JUSTICE
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10700 N KENDALL DR STE 401
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1475
Mailing Address - Country:US
Mailing Address - Phone:305-270-7999
Mailing Address - Fax:305-270-6788
Practice Address - Street 1:10700 N KENDALL DR STE 401
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1475
Practice Address - Country:US
Practice Address - Phone:305-270-7999
Practice Address - Fax:305-270-6788
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014845367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife