Provider Demographics
NPI:1659151868
Name:LUNDI, MOISE (APRN)
Entity Type:Individual
Prefix:
First Name:MOISE
Middle Name:
Last Name:LUNDI
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20410 NW 9TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2372
Mailing Address - Country:US
Mailing Address - Phone:305-308-3009
Mailing Address - Fax:
Practice Address - Street 1:16125 NE 18TH AVE
Practice Address - Street 2:
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4749
Practice Address - Country:US
Practice Address - Phone:305-627-3208
Practice Address - Fax:833-471-5031
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9275703363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care