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Organization
ADVANCE PRACTICE/FINE FOR NO REASSON
Active
Organization
ADVANCE PRACTICE/FINE FOR NO REASSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRLEY MOISE DNP (DOCTOR OF NURSING PRACTICE)
(954) 834-3669
Entity
Organization
Contact information
Practice address
11600 NW 18TH ST, PEMBROKE PINES, FL 33026-2057
(954) 834-3669
Mailing address
11600 NW 18TH ST, PEMBROKE PINES, FL 33026-2057
(954) 834-3669
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
251J00000X
Nursing Care Agency
—
NULL
302R00000X
Health Maintenance Organization
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163704-00
—
FL
Enumeration date
05/15/2021
Last updated
05/15/2021
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