Provider Demographics
NPI:1326804865
Name:CYNTHIA DEVEAUX-MOONA CONCIERGE NURSE PRACTITIONER SERVICES LLC
Entity Type:Organization
Organization Name:CYNTHIA DEVEAUX-MOONA CONCIERGE NURSE PRACTITIONER SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVEAUX MOONA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:941-780-1671
Mailing Address - Street 1:8945 52ND AVE E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-8971
Mailing Address - Country:US
Mailing Address - Phone:941-780-1671
Mailing Address - Fax:
Practice Address - Street 1:8945 52ND AVE E
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-8971
Practice Address - Country:US
Practice Address - Phone:941-780-1671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty