Provider Demographics
NPI:1780937771
Name:MCLEOD-MOYA, CATHERINE (RN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MCLEOD-MOYA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4049
Mailing Address - Country:US
Mailing Address - Phone:305-904-5175
Mailing Address - Fax:
Practice Address - Street 1:6601 S.W. 80 ST SUITE 107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143
Practice Address - Country:US
Practice Address - Phone:305-668-8644
Practice Address - Fax:305-668-6010
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FL9465710163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst