Organization
NIBERTO A MORENO MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIBERTO ANGEL MORENO MD (OWNER)
(305) 775-9839
Entity
Organization
Contact information
Practice address
9195 SW 72ND ST STE 200, MIAMI, FL 33173-3488
(305) 775-9839
Mailing address
9195 SW 72ND ST STE 200, MIAMI, FL 33173-3488
(305) 775-9839
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME105336
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME105336
MEDICAL LICENSE
FL
Enumeration date
05/20/2016
Last updated
10/28/2019
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