Provider Demographics
NPI:1255424636
Name:MOYA, FLOR VENERACION (ARNP)
Entity type:Individual
Prefix:MISS
First Name:FLOR
Middle Name:VENERACION
Last Name:MOYA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:FLORDELIZA
Other - Middle Name:VENERACION
Other - Last Name:MOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2275 BISCAYNE BOULEVARD
Mailing Address - Street 2:# 801
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137
Mailing Address - Country:US
Mailing Address - Phone:305-573-7833
Mailing Address - Fax:
Practice Address - Street 1:MIAMI VA HEALTH CARE SYSTEM
Practice Address - Street 2:1201 NW 16TH STREET
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137
Practice Address - Country:US
Practice Address - Phone:305-324-4455
Practice Address - Fax:305-575-3149
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1017572363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health