Provider Demographics
NPI:1043045826
Name:MOYER, FIJI ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:FIJI
Middle Name:ANN
Last Name:MOYER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3137 OAK HAMMOCK LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-6052
Mailing Address - Country:US
Mailing Address - Phone:615-631-2376
Mailing Address - Fax:
Practice Address - Street 1:1891 CAPITAL CIR NE STE 2
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4486
Practice Address - Country:US
Practice Address - Phone:850-877-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL42186225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist