Individual
SANDRA L MOONAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8333 W MCNAB RD, SUITE 205, TAMARAC, FL 33321-3242
(954) 934-3209
Mailing address
8333 W MCNAB RD, SUITE 205, TAMARAC, FL 33321-3242
(954) 934-3209
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA56294
FL
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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